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nudge me quiz

I've put together the nudge me quiz below to help people take a moment to stand back and think about what really matters to them, and what might be currently stopping them from achieving things they want to so that they can make the necessary changes, and feel secure, that they are focusing on their important stuff.

Feel free to complete the electronic version below and send it through to me. Then, for a limited time, once I receive it, I'll reply giving you a gentle nudge to help you move in the direction you want to go. I do this by asking some simple questions to nudge you along! This is free, entirely confidential and you don't even have to fill in your name if you'd rather not. Alternatively, you can complete the quiz solely for your own purpose by printing out the word version.

Name:

Email*:

Are you age:

Marital Status:

Have children:

Employment status:

* please state work/profession here:

Q1 Which one of the following tends to preoccupy your mind more than anything else? IF more than one of the areas is often on your mind, please rank in order 1-5 (1 = more often and 5 = least often.):

My relationship - or wanting one:

My children - or wanting them:

My work/career/business - or wanting to work/have a career/business:

My finances:

My health and fitness:

Other:

Q2 Looking into the future, please rank the following 1-4 in order of which causes you most concern? (1 = most and 4 least.):

Achieving a lifestyle that seems me living my life to the full with no regrets.:

Ensuring that my parents/relatives are cared for and looked after in older age.:

Wanting to give something back in the wider sense/help people less fortunate than myself.:

Global issues eg, protecting the environment, tackling poverty.:

Other:

Q3 Which 3 dreams or goals would you like to achieve in the next year, that would make you even happier and more fulfilled than you are now?:

Q4 What currently stops you/is preventing you from achieving these 3 goals/dreams?:

Q5 What would have to happen for you to overcome/deal with these factors?:

Q6 What are the first 3 things you would do if you received a large windfall of cash where money became no object?:

Q7 If you had 100% guarantee that you would succeed in achieving one wish, ambition or goal right now, what would that one thing be?:

Any other comments?:

Privacy:

I respect your privacy and will never divulge your details to anyone, or pass them on to a third party.  Please indicate your agreement to confirm you have understood the nudgeme privacy terms.

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