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Application

First Name

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Last Name

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Email Address

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What best describes you?

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What best describes you?

Executive or C-suite leader

Founder or co-founder

Entrepreneur or business owner

High performing professional

Other

What's your biggest sleep challenge right now?

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What's your biggest sleep challenge right now?

I can't fall asleep. My mind won't stop running at night

I fall asleep fine but wake up in the middle of the night and can't get back to sleep

I sleep through the night but wake up exhausted no matter how many hours I get

All of the above. It varies night to night

It's a different challenge for me

How long have you been struggling with your sleep?

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How long have you been struggling with your sleep?

A

Less than 6 months

B

6 months to a year

C

1 to 3 years

D

More than 3 years

What have you already tried to improve your sleep? (Select all that apply)

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What have you already tried to improve your sleep? (Select all that apply)

Melatonin or other supplements

Prescription sleep medication

Meditation or breathing apps

Therapy or counseling

Dietary or lifestyle changes

Sleep hygiene protocols

Other programs or coaches

Nothing yet

Do you currently use any sleep tracking tools?

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Do you currently use any sleep tracking tools?

Yes, a wearable like Oura, Whoop, or Apple Watch

Yes, a phone app

I have in the past but not currently

No I don't track my sleep

Do you have any diagnosed sleep disorders such as sleep apnea, insomnia disorder, or restless leg syndrome?

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Do you have any diagnosed sleep disorders such as sleep apnea, insomnia disorder, or restless leg syndrome?

Yes, diagnosed and currently being treated

Yes, diagnosed but not currently being treated

I suspect I might but haven't been diagnosed

No diagnosed sleep disorders

What would change in your life if you slept well consistently?(This is the most important question on the form. Take a minute with it.)

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