Home » What I want What I want Page 1 Page 3 Page 3 Page 4 Name What do you want? This survey is aimed at helping to serve you for your highest good. So that you can become the best of your full potential. Tell me what you would really like help with. First Name * Last Name * Email Address * What is your greatest stress or challenge right now? What is your stress or challenge? Rate the level of stress 1-10 (10 highest level of stress) 1 2 3 4 5 6 7 8 9 10 What do you think could move you beyond this stress? What could help you? I don't know I am willing to try anything You tell me what is the best way forward What you think could help you? How quick do you want change? How quick do you want change? Immediate It can take as long as needed Very urgent Not urgent I am coping for now What is the best method of communication for you? Email Skype What'sApp Facebook Messenger Live chat Phone What methods of help do you prefer? do it myself with a little help be guided, step-by-step learn how to help myself all the time completely on my own, find my own way Anything else you want to tell me?