SurveyZone 1 | Future Selfing

"*" indicates required fields

Emotional Environment: Growing up, how stressed were the the adults around?*

Daily Stress: When life feels heavy, stressful, intense, or even boring > Do you look for ways to escape the situation/yourself; a drink, excessive scrolling, binge TV, weed, pills...*

Rarely	Daily	Weekly

Daily Emotions:*

Always Rushing	My Day/My Pace	Emotional Rollercoaster

Home Environment: As an infant/toddler I was in the environment of: addiction, arguing, and/or conflict.*

Almost Never	Rarely	Often	"My Normal"

Early Survival: As an infant, were your physical needs consistently met: a safe home, quality sleep (not constantly changing or in unsettling environments), good nutrition, positive physical touch, medical care, etc.? Answer based on your best sense from later childhood experiences and family stories.*

Unsteady	Fairly Unsteady	They Tried Their Best	Great Environment

Availability: How important is having quick access to substances that help you escape or unwind: alcohol, weed, pills, or other substances even if you are not craving?*

Not An Issue	Usually Available	I Stayed Stocked

Social Anxiety: In social situations I reach for a drink, Xanax, weed, stay near friends, all to feel more comfortability?*

Almost Never	Strong Intervert	Often	Always

Mothers Pregnancy: From what I know, my mother went through high stress during pregnancy. She didn’t have the emotional tool, physical support and/or emotional support.*

Stable Environment	Manageable Stress	Difficult

Challenges: When daily challenges, other peoples emotions and/or surprises hit me.*

I'm A Spirit Warrior	Struggle With Anxiety	Receive Others Stress	Mildly Affected

Planning: Life requires me to have multiple back-up plans.*

I Trust My Primary Plan	Usually	Yes

Daily Mindset: Most days I have trouble staying in Universal trust.*

I Was Born Lucky	Only Work = Trust	Somewhat	Struggle With Trust

Holding Tension: In stressful situations my body and mind is overwhelmed.*

Constantly	It's An Issue	I Breath Through It

Output: Usually when I look back on my week and compare them to my goals I feel like?*

I Keep Falling Short	Satisfied	50/50

Would You Like Your Energy Roadmap Sent to You?

Strong move, most men don't pause to check-in. Uncover the next five zones influencing your actions.

You have Successfully Subscribed!

Would You Like Your Energy Roadmap Sent to You?

Strong move, most men don't pause to check-in. Uncover the next five zones influencing your actions.