Brief Questionnaire

Thank you for visiting us. It is our honor to work with you and in doing so we want you to have the best results when it comes to your wellness.

    By answering the questions below, it will give us a glimpse into your life and a starting point to what is important for you to achieve. Please answer all the questions below. They will provide feedback as to how we can support you on your journey of growth and achievement.

    What brought you to ReikiPagoda.com?

    What is your biggest challenge that you are hoping to resolve?

    What are you most frustrated by, with life, wellness, and maintaining a balanced lifestyle?

    What are your dreams and/or aspirations? What would you like to accomplish?

    What do you think you need to get from where you are to where you want to be with a wellness lifestyle?

    What do you need to grow, advance, or obtain more optimal wellness?

    What have you tried already?

    What didn’t work?

    Are you ready to take control of your overall wellness (mind, body, and spiritual well-being)?
    YesI'm looking for more informationNo

    Thank you for sharing! This is a great first step to find solutions and improving your lifestyle.
    We look forward to connecting with you soon.

    In the meantime if you have any questions or concerns please contact us at hello@reikipagoda.com