// GETTING STARTED

Name:
Email:
Phone:
Address/Location:
How did you find out about Jacqueline Hellyer?
Part A: Let's start by getting a snapshot of how your life is at the moment.
How would you rate these twelve areas of your life? (1 low - 10 high)
• Fun	1  2  3  4  5  6  7  8  9  10
• Home	1  2  3  4  5  6  7  8  9  10
• Body	1  2  3  4  5  6  7  8  9  10
• Mind	1  2  3  4  5  6  7  8  9  10
• Soul	1  2  3  4  5  6  7  8  9  10
• Work	1  2  3  4  5  6  7  8  9  10
• Creativity	1  2  3  4  5  6  7  8  9  10
• Money	1  2  3  4  5  6  7  8  9  10
• Friends	1  2  3  4  5  6  7  8  9  10
• Family	1  2  3  4  5  6  7  8  9  10
• Love	1  2  3  4  5  6  7  8  9  10
• Contribution	1  2  3  4  5  6  7  8  9  10

Part B: Now let's look at specific issues in your life.
	Are the various parts of your life in balance?	Yes No
	If not, are you ready to create that balance?
	Is your life on track?	Yes No
	If not, do you want to become clear on what you really want in life and how to get it?
	Are you going through a life change?	Yes No
	If yes, are you willing to make the most of the opportunities this change presents?
	Is your life too complex, busy or overwhelming?	Yes No
	If so, are you prepared to start simplifying and decluttering?
	Is your life interesting, fun and joyful?	Yes No
	If not, are you game to add some zest?

And overall:
On a scale from one to ten, how committed are you to engaging in the process of making your life great?
1  2  3  4  5  6  7  8  9  10

Other Comments:

And that's it. Just hit the send button and I'll get back to you shortly.