Certified Self Care Consultant

Self Care Survey

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This Mini Self Care Survey gives you an idea of what you will address and discuss with your Certified Self Care Consultant.

All completed surveys will be entered into a monthly drawing for a Mini Relax and Pamper Kit. Submitting this survey in no way obligates you to accept any services.

Name
Phone Number
Email Address
I currently have a daily care regimen
My body feels tense or inflexible
I'd like to try natural fragrances, oils and products
I'd like to start a preventative wellness regimen
Even though I feel pretty good about my health, I'm looking for new ways to support it
I have difficulty relaxing
I feel stressed out or overwhelmed
I'd like to experience the benefits of Aromatherapy
I'd love to spend more nurturing time with my family and friends
I'd love to explore ways to relax and pamper myself
I'd like a Certified Self Care Consultant to contact me regarding this Self Care Survey

IMPORTANT NOTE: Your privacy is taken very seriously. All of your information is kept confidential and private. If you have any concerns about how this personal information is handled please do not hesitate to send an email so that your concerns may be addressed.

For questions, comments or to receive more information send an email or call (678) 534-3395.