1. How do you feel in your body most days?

2. How often do you experience pain or discomfort?

Rarely Occasionally Frequently Daily

3. Do you feel connected to your body?

Yes, very connected Sometimes Not really I avoid thinking about it

4. How would you describe your sleep quality?

5. How is your digestion?

Smooth Irregular Constipation or bloating Sensitive to certain foods

6. How would you describe your current relationships?

Supportive and loving Stable but distant Full of conflict I feel isolated

7. Do you feel emotionally safe expressing yourself?

Always Sometimes Rarely Never

8. Is there any unresolved hurt or baggage affecting you?

Yes Maybe I’m not sure No

9. How do you feel emotionally most of the time?

10. How often do you feel stressed?

Almost never Occasionally Frequently Almost all the time

11. What thoughts dominate your mind?

12. Do you practice self-care or mindfulness?

Yes, daily Sometimes Rarely I don’t know where to start

13. Do you feel a sense of belonging?

Yes Sometimes Not really I feel left out

14. How often do you socialize?

Daily Weekly Once in a while Rarely

15. Do you feel seen and heard by others?

Always Occasionally Seldom Never

16. What do you feel is missing in your life?

17. If your body could speak, what would it say?

18. What version of yourself do you wish to grow into?

19. Have you ever done healing or spiritual work?

Yes, regularly A little bit No, but I’m open No

20. Why have you joined Hari Om Smiles? What are you seeking?