🦉 Wellness Assessment Questionnaire
At Zen Curiosity, we offer you different approaches to wellness support: sound therapy, lithotherapy, aromatherapy, as well as other gentle practices offered by our experienced collaborators.
Our intention is simple: to offer you a moment just for you, to allow you to refocus, breathe and rediscover your inner harmony.
We know that each person is unique and that each body has its own resonance. When our vibrations are aligned, we experience a deep balance and a true sense of well-being.
However, this balance can sometimes be disrupted by tensions, whether physical, emotional, or related to periods of stress.
The gentle approaches we offer are designed to gently guide you towards a reharmonization of body and mind, in order to rediscover a more peaceful inner rhythm.
To best guide you, we will begin with a personalized welcome, listening to your needs and your current state.
That's why we've created a questionnaire, available for download (PDF file). You can fill it out at your leisure at home and send it back to us.
📝 Pricing & Delivery Times |
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1. Simple version - 3-5 line answer: €1.00 |
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2. Detailed version, organized by order of priority - Response of 5 to 20 lines: €12.00 |
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3. Very detailed version, organized by order of priority - Response of 20 to 50 lines: €37.00 |
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4. Premium version, very detailed report, organized in order of priority of 50 lines and you receive a set adapted to your needs:
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- Completion time: between 3 and 10 days |
Once your questionnaire has been reviewed by our team, you will receive a personalized assessment, designed to provide you with the most tailored support and a truly customized experience. This assessment will include wellness advice specifically chosen for you: types of yoga or exercise, crystal therapy or other therapies, Feng Shui, incense, essential oils, and more.
| 📥 "Click here to access the questionnaire download and online payment" |
| 📧 Click here to send us the questionnaire to our email address |
👁️ Preview of the downloadable PDF file ⤵
🦉 Wellness Assessment Questionnaire
1. General Data
- Age : ______
- Gender: ☐ Male ☐ Female ☐ Other ☐ Prefer not to say
- Weight: ______ kg
- Size: ______ cm
- Physical activity level: ☐ Sedentary ☐ Moderate ☐ Active ☐ Very active
2. Sleep
- How many hours do you sleep on average per night? ☐ <5h ☐ 5–6h ☐ 6–7h ☐ 7–8h ☐ >8h
- Perceived quality of your sleep: ☐ Poor ☐ Average ☐ Good ☐ Very good
3. Energy & Stress
- Average energy level during the day: ☐ Very low ☐ Low ☐ Medium ☐ Good ☐ Very good
- Do you experience stress regularly? ☐ Never ☐ Sometimes ☐ Often ☐ Very often
- Main causes of stress (multiple choice): ☐ Work ☐ Family ☐ Health ☐ Finances ☐ Other: _______
4. Food
- Do you follow a specific diet? ☐ Vegetarian ☐ Vegan ☐ Gluten-free ☐ Keto ☐ None
- Frequency of fruit/vegetable consumption: ☐ Rarely ☐ 1x/day ☐ 2–3x/day ☐ >3x/day
- Do you drink enough water each day? ☐ Yes ☐ No ☐ I don't know
5. Personal goals
What are your main objectives? (max 3)
☐ Improve my sleep
☐ Managing my stress
☐ Eat better
☐ Have more energy
☐ Do more exercise
☐ Lose weight
☐ Other: _______
6. General emotional state
How are you feeling right now?
☐ Calm
☐ Stressed
☐ Anxious
☐ Serene
☐ Emotionally exhausted
☐ Motivated
☐ Other: ______________________
Are you experiencing any particular difficulties at the moment?
☐ Yes → Please specify: ______________________
☐ No
7. Physical pain or tension
Do you experience any pain or tension? (multiple choice)
☐ Back
☐ Neck / Trapezius muscles
☐ Shoulders
☐ Legs
☐ Headaches / Migraines
☐ Joints
☐ None
☐ Other: ______________________
These discomforts are:
☐ Occasional
☐ Frequent
☐ Daily Newspapers
9. Energy sensitivity
Do you feel you can easily perceive or sense the variations in energy around you (people, places, situations, waves...)?
☐ Yes
☐ No
☐ I don't know
10. Preferences in natural wellness
What types of support do you prefer?
☐ Yoga & breathing
☐ Sound relaxation (bowls, chimes…)
☐ Mineral Advice
☐ Incense & Aromas
☐ Gentle body exercises
☐ Guided Meditations
☐ Spiritual Approach
☐ More of a physical/concrete approach
☐ Other: ______________________
💗 Thank you