NeuroAwakening Questionnaire

Basic Information

First name

Last name

What is the primary purpose of this meditation for you?

What specific challenge, intention, or desired outcome would you like the meditation to address?

Tone and Style: Would you prefer a calming and grounding meditation, an uplifting and energizing one, or a combination of both?

Calming/Grounding

Uplifting/Energizing

Combination

Audio Elements: Do you enjoy ambient background sounds, or just voice?

Ambient Background

Voice

How are you currently feeling, emotionally and physically?

Are there any specific stressors or triggers you’d like the meditation to help ease?

Do you have a favorite place, memory, or imagery you’d like included?

What is your preferred meditation length?

10-15 minutes

15-20 minutes

20-25 minutes

Is there anything else you’d like me to know to make this meditation truly yours?