[et_pb_section fb_built=”1″ admin_label=”Header” _builder_version=”4.27.4″ _module_preset=”default” background_enable_color=”off” use_background_color_gradient=”on” background_color_gradient_stops=”rgba(39,41,47,0.51) 0%|rgba(39,41,47,0.41) 100%” background_color_gradient_overlays_image=”on” background_image=”https:\/\/healthandlifeonline.com\/wp-content\/uploads\/2025\/10\/holistic-image-11.jpg” width=”94%” width_tablet=”80%” width_phone=”80%” width_last_edited=”on|desktop” max_width=”2000px” module_alignment=”center” custom_margin=”60px||60px||true|false” custom_padding=”6vw||6vw||true|false” border_radii=”on|10px|10px|10px|10px” locked=”off” collapsed=”on” global_colors_info=”{}”][et_pb_row _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”78f53a24-e535-423d-82a4-ccc335dd7b69″ text_font=”Prata||||||||” text_text_color=”#FFFFFF” text_font_size=”72px” header_text_color=”#FFFFFF” text_orientation=”center” text_font_size_tablet=”40px” text_font_size_phone=”30px” text_font_size_last_edited=”on|phone” header_font_size_tablet=”” header_font_size_phone=”30px” header_font_size_last_edited=”on|phone” locked=”off” global_colors_info=”{}”]<\/p>\n
Questionnaire<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”About” _builder_version=”4.27.4″ _module_preset=”default” custom_margin=”0px||||false|false” custom_padding=”0px||||false|false” locked=”off” collapsed=”on” global_colors_info=”{}”][et_pb_row _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”default” text_font=”||||||||” text_text_color=”gcid-secondary-color” text_font_size=”20px” hover_enabled=”0″ text_orientation_tablet=”center” text_orientation_phone=”center” text_orientation_last_edited=”on|tablet” global_colors_info=”{%22gcid-secondary-color%22:%91%22text_text_color%22%93}” sticky_enabled=”0″]<\/p>\n
\n Pre-Session Assessment\n <\/p>\n
\n Please take a few minutes to complete this questionnaire. Your answers will help me understand your current situation and goals, so I can better support you.\n <\/p>\n
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form_field_text_color=”#5a4a3f” custom_button=”on” button_text_size=”16px” button_text_color=”#ffffff” button_bg_color=”#4a3427″ button_bg_enable_color=”on” sticky_enabled=”0″ form_field_font_size=”16px”][et_pb_contact_field field_id=”Name” field_title=”Name” _builder_version=”4.27.6″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Email” field_title=”Email Address” field_type=”email” _builder_version=”4.16″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Phone” field_title=”Phone” required_mark=”off” _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Date_of_Birth” field_title=”Date of Birth (YYYY\/MM\/DD)” _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”current_situation” field_title=”How would you describe your current well-being?” field_type=”radio” radio_options=”%91{%22value%22:%22Excellent%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Good%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Fair%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Needs Improvement%22,%22checked%22:0,%22dragID%22:2}%93″ fullwidth_field=”on” _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”current_situation_2″ field_title=”Have you ever worked with a coach, therapist, or advisor before?” field_type=”radio” radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0}%93″ required_mark=”off” fullwidth_field=”on” _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Goals” field_title=”Your Goals – What motivated you to seek coaching\/advisory services at this moment?” field_type=”text” fullwidth_field=”on” _builder_version=”4.27.4″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Background_Information_1″ field_title=”Have you received any medical diagnosis that may be relevant to your current situation?” field_type=”radio” radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Prefer not to answer%22,%22checked%22:0,%22dragID%22:1}%93″ required_mark=”off” fullwidth_field=”on” _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Background_Information_2″ field_title=”Are you currently under the care of a healthcare professional (doctor, psychologist, psychiatrist)?” field_type=”radio” radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0}%93″ required_mark=”off” fullwidth_field=”on” _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Background_Information_3″ field_title=”Are you currently taking any medication, supplements, or other health-related products?” field_type=”radio” radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Not Sure%22,%22checked%22:0,%22dragID%22:1}%93″ required_mark=”off” fullwidth_field=”on” _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Preferences_1″ field_title=”How would you like to work together?” field_type=”checkbox” checkbox_options=”%91{%22value%22:%22One-on-one online sessions%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Group sessions%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Workshops \/ Programmes%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Not sure yet%22,%22checked%22:0,%22dragID%22:2}%93″ required_mark=”off” fullwidth_field=”on” _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Preferences_2″ field_title=” What times are generally most convenient for you?” field_type=”checkbox” checkbox_options=”%91{%22value%22:%22Mornings%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Afternoons%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Evenings%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Weekends%22,%22checked%22:0,%22dragID%22:2}%93″ required_mark=”off” fullwidth_field=”on” _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Consent” field_title=”Consent & Privacy” field_type=”checkbox” checkbox_options=”%91{%22value%22:%22I confirm that I understand this questionnaire and the advisory sessions are not a substitute for medical diagnosis or treatment.(obligatory)%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22I agree that my personal data may be used exclusively for providing coaching\/advisory services and to respond to my request.%22,%22checked%22:0,%22dragID%22:0}%93″ required_mark=”off” fullwidth_field=”on” _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][\/et_pb_contact_form][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"
Questionnaire Pre-Session Assessment A few questions before we begin Please take a few minutes to complete this questionnaire. Your answers will help me understand your current situation and goals, so I can better support you.<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-100457","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/healthandlifeonline.com\/de\/wp-json\/wp\/v2\/pages\/100457","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthandlifeonline.com\/de\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/healthandlifeonline.com\/de\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/healthandlifeonline.com\/de\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/healthandlifeonline.com\/de\/wp-json\/wp\/v2\/comments?post=100457"}],"version-history":[{"count":19,"href":"https:\/\/healthandlifeonline.com\/de\/wp-json\/wp\/v2\/pages\/100457\/revisions"}],"predecessor-version":[{"id":103826,"href":"https:\/\/healthandlifeonline.com\/de\/wp-json\/wp\/v2\/pages\/100457\/revisions\/103826"}],"wp:attachment":[{"href":"https:\/\/healthandlifeonline.com\/de\/wp-json\/wp\/v2\/media?parent=100457"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}