Integrative Therapeutics Curivate Protocol Questionnaire

How are you feeling during a typical day?

Stressed out and tired

Nervous and overwhelmed

I’m managing

Which best describes your current healthcare journey?

I am well on my way to wellness and it is a priority.

I am looking to make a change in my wellness routine and make it a priority.

My wellness is not my priority at this time.

How confident do you feel when it comes to making choices about your overall health and wellness routine?

Very Confident

Mildly Confident

Not Confident

Which one of these scenarios best describes you?

I have a busy life with competing priorities, which leaves me feeling stressed and exhausted. When I lay down at night, I sometimes struggle to get the sleep I need because I’m wired.

I have ruminating, and unwanted thoughts , which occasionally leaves me feeling anxious or nervous.

I am a driven individual who has a busy life and wants to accomplish everything. I find myself running out energy before my to-do list is done for the day.

Which one of the following scenarios do you most identify with?

I occasionally toss and turn at night, thinking about tomorrow’s to do list.

I find myself questioning every decision I make, unable to concentrate on the tasks I have to complete for the day.

I feel the need to stay sharp and on my toes all day long to get through each day.

Which scenario do you struggle the most with?

(Sometimes) Getting a poor night of sleep, and not having the energy to get through the day.

Experiencing a dip in mood or no motivation when it comes to tackling the day.

Forgetfulness and racing thoughts as I tackle the day.

Integrative Therapeutics Curivate Protocol Questionnaire

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