Page 1 of 1

Human Intellect

What is your name?

*

How can we reach you?( Mobile Number)

*

What best describes your current situation?

*

How have you been feeling lately?

*

How have you been feeling lately?

A

Mostly calm

B

Slightly stressed

C

Frequently anxious

D

Emotionally drained

E

Completely overwhelmed

What are you hoping to get from this support?

*

What are you hoping to get from this support?

A

Clarity in life or career

B

Better mental peace

C

Improved focus and productivity

D

Emotional support

E

Personal growth

How soon would you like support?

*

What kind of support would you prefer?

*

What kind of support would you prefer?

A

One-on-one conversation

B

Group sessions

C

Workshops and guidance

D

Not sure yet

Are you open to joining a growth-focused community with mentorship, workshops, and support?

*

Are you open to joining a growth-focused community with mentorship, workshops, and support?

A

Yes, definitely

B

Maybe, tell me more

C

Not sure yet

D

No