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Sophrology online workshops
*
Indicates required field
This questionnaire will help the Sophrologist develop a series of Sophrology workshops appropriate to the clients’ needs. The workshop is delivered over eight weeks, with each session lasting 1 hour.
We will treat all information provided in the strictest confidence, and all details will remain private.
Name
*
First
Last
Email
*
What is your age?
*
Up to 21
22 – 35
36 – 45
46 – 55
Over 55 (please state)
Age if over 55:
*
Reasons for wanting to attend the workshop
*
Stress
Sleep problems
Anxiety
Depression
Managing emotions
Self-development
General interest
Other (please state)
Other reasons:
*
What methods do you currently use to help you with the above?
*
Have you ever practised any organised relaxation, meditation, or self-development class before?
*
Yes
No
Do you have any difficulties with breathing exercises or visualisations?
*
Yes
No
Do you suffer from pain or limited movements in any joints?
*
Yes
No
Are you pregnant?
*
Yes
No
Describe in a few sentences how stress affects you:
*
What would you most like to get from the workshop?
*
Please answer the following questions below using a scale of 1 to 10, where 1 is extremely low/poor/negative and 10 is extremely high/good/positive. For each, try to write one sentence, phrase or word that best describes the rating you have chosen.
Overall health and well-being?
*
1
2
3
4
5
6
7
8
9
10
My overall health and well-being:
*
Everyday energy levels?
*
1
2
3
4
5
6
7
8
9
10
My everyday energy levels:
*
Quality of sleep?
*
1
2
3
4
5
6
7
8
9
10
My quality of sleep:
*
Level of stress/anxiety?
*
1
2
3
4
5
6
7
8
9
10
My level of stress/anxiety:
*
Level of self-confidence?
*
1
2
3
4
5
6
7
8
9
10
My level of self-confidence:
*
Level of concentration?
*
1
2
3
4
5
6
7
8
9
10
My level of concentration:
*
Ability to relax?
*
1
2
3
4
5
6
7
8
9
10
My ability to relax:
*
When is the most convenient time for you to attend the workshop? (select all that apply)
*
Weekday lunchtimes
Weekday evenings
Saturday morning
Saturday afternoon
Saturday evening
Sunday morning
Sunday afternoon
Sunday evening
Other (please specify)
Other specific times:
*
Any other comments:
*
Date questionnaire completed:
*
Send Questionnaire
Home
Online Timetable
Studio Timetable
Prices
Terms and Conditions
Covid Policy and Procedures
About
Contact Us
Classes
Testimonials
Retreat Studio
Pilates
Back4Good
Pilates for Fitness
Meno Active
Gentle Moves
Somatics Exercise
Yoga
Sophrology
Questionnaire
Qigong
ChiBall
