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Coaching Survey
This survey helps determine whether we are a good fit to work with each other. It includes a few questions about your past experiences and what you’re willing to do moving forward.
It takes about 3 minutes.
Name
*
Email
*
Have you been medically diagnosed with Tinea Versicolor?
*
A
Yes
B
No
C
I was diagnosed with a different diagnosis that looks like Tinea versicolor
On a scale of 1 to 10, how severe would you say your skin condition has become has become?
*
0
1
2
3
4
5
6
7
8
9
10
How many doctors have you seen about this condition?
*
A
None
B
1–2
C
3–5
D
More than 5
Where is the majority of your TV located?
*
Chest
Shoulders
Stomach
Back
Neck
Face
Arms
Other
Has the Tinea always been present or does it go away and come back
*
A
Always present
B
Seasonal
C
Varies with my diet
D
Other
How long have you had Tinea?
*
Are you willing to share a photo of your current skin condition?
*
A
Yes
B
No
Have you found yourself avoiding things because of it?
Physical activity (sweating, exercise)
Clothing choices
Intimacy or closeness
Photos or social situations
Other
What's making you consider a coaching program?
*
A
General health improvement
B
An upcoming wedding, vow renewal, photoshoot, or event
C
Frustration after another relapse
D
Other
Was there ever a stretch of time where it was under control or mostly gone? What were you doing differently at that time?
*
Anything else you want me to know before we talk?
*
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