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EmpowerHER Client Questionnaire

Hello Lovely!

This questionnaire is your space to share your unique journey and help me understand how we can work together to create the life you envision. There are no right or wrong answers—just honest reflections of where you are now and where you want to be. If you feel like writing a novel, go for it! Let it all out—I’m here for it, girl! The more you share, the better I can support you.

Your Health & Wellness Journey

Health, Fitness & Nutrition

Drugs & Alcohol

Toxins & Clean Living

Screen Time & Media Consumption

Your Wealth & Abundance

Your Lifestyle & Aspirations

Your Why

Your Support System

Self-Reflection

Thank You & Final Note

Thank you for taking the time to be so open and honest in sharing your journey. Your willingness to be vulnerable allows me to better understand your needs and serve you in the most supportive and empowering way possible.

Please remember that everything you’ve shared is held in the strictest confidence, with zero judgment—only support, understanding, and encouragement as we work together to create the life you envision.

I’m honored to walk alongside you on this path. Let's do this, together!🔥

 

Yours in Health, Wealth & Abundance 

Corrie 

The Unregistered Nurse 🎀

Thanks for submitting!

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