BM Collective

The BM Collective Survey

First Name

Last Name

What is it that you desire most from life?

Why is this desire important to you?

What percentage of that desire would you say you've successfully achieved thus far?

What have you identified as being the barrier(s) to you achieving that desire?

If you could rewrite any steps previously taken, what would you do differently?

Choose the first 3 words that come to mind when describing yourself.

In which scenario listed below do you feel you would operate with more impact?

Working alone

Collaborating with 1-2 others

Playing a role with a larger team

List the skill(s) that you would improve upon to increase your efforts of progression.

List the achievement(s) you are most proud of.

What amount of sleep/rest is necessary for you to function fully?

7 or more hrs

5-6 hrs

less than 5 hrs

How many meals do you routinely eat per day?

4 or more meals

2-3 meals

Maybe 1; snacking

How would you rate your average daily stress level on a scale of 1-10? (1=low;10=high)

How many minutes of moderate exercise are you averaging per week?

List all forms of therapy you routinely practice over any given month.

What is your current relationship status?

Married

Divorced

Committed

Single

Including yourself, how many people live with you?

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