{"id":4783,"date":"2024-09-21T04:44:54","date_gmt":"2024-09-21T02:44:54","guid":{"rendered":"https:\/\/lifecalma.com\/?page_id=4783"},"modified":"2024-10-06T18:55:17","modified_gmt":"2024-10-06T16:55:17","slug":"questionnaire","status":"publish","type":"page","link":"https:\/\/lifecalma.com\/index.php\/questionnaire\/","title":{"rendered":"Questionnaire"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:0px;--awb-padding-right:150px;--awb-padding-left:150px;--awb-margin-top:131px;--awb-background-color:var(--awb-color6);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-blend:overlay;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:0%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:0.096%;--awb-width-medium:100%;--awb-spacing-right-medium:0%;--awb-spacing-left-medium:0.096%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-4771\"><form id=\"wpforms-form-4771\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"4771\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php\/wp-json\/wp\/v2\/pages\/4783\" data-token=\"2cbdb1ec6274dcebb9d358f16e2090d9\" data-token-time=\"1782161513\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-hidden\" id=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-4771-field_67-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"67\"><div id=\"wpforms-4771-field_67\" class=\"wpforms-field-medium wpforms-field-row\" aria-errormessage=\"wpforms-4771-field_67-error\"><p><img decoding=\"async\" height=\"400\" width=\"752\" alt=\"\" src=\"https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST.avif\" class=\"aligncenter size-full wp-image-5473\" srcset=\"https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST-200x106.avif 200w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST-300x160.avif 300w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST-400x213.avif 400w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST-600x319.avif 600w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST.avif 752w\" sizes=\"(max-width: 752px) 100vw, 752px\" \/><\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-4771-field_78-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"78\"><h3 id=\"wpforms-4771-field_78\" aria-errormessage=\"wpforms-4771-field_78-error\">GENERAL INFO<\/h3><\/div><div id=\"wpforms-4771-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><fieldset><legend class=\"wpforms-field-label\">1. GENERAL INFO: Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-4771-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" aria-errormessage=\"wpforms-4771-field_0-error\" required><label for=\"wpforms-4771-field_0\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-4771-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" aria-errormessage=\"wpforms-4771-field_0-last-error\" required><label for=\"wpforms-4771-field_0-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-4771-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_1\">Country and State of residence? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-4771-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" spellcheck=\"false\" aria-errormessage=\"wpforms-4771-field_1-error\" required><\/div><div id=\"wpforms-4771-field_24-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"24\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_24\">Age <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-4771-field_24\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][24]\" spellcheck=\"false\" aria-errormessage=\"wpforms-4771-field_24-error\" required><\/div><div id=\"wpforms-4771-field_25-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_25\">Marital status, Children (ages, if any). <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-4771-field_25\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][25]\" spellcheck=\"false\" aria-errormessage=\"wpforms-4771-field_25-error\" aria-describedby=\"wpforms-4771-field_25-description\" required><div id=\"wpforms-4771-field_25-description\" class=\"wpforms-field-description\">This will help me understand your close environment.<\/div><\/div><div id=\"wpforms-4771-field_8-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_8\">2. QUESTIONS ABOUT YOUR ANXIETY: How long have you been suffering from anxiety? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_8\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][8]\" aria-errormessage=\"wpforms-4771-field_8-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_9-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_9\">What type(s) of anxiety are you suffering from (social, generalized etc)? Please let me know if you have been diagnosed with anxiety or if it&#039;s a self report (both are ok for me).<\/label><textarea id=\"wpforms-4771-field_9\" class=\"wpforms-field-small\" name=\"wpforms[fields][9]\" aria-errormessage=\"wpforms-4771-field_9-error\" aria-describedby=\"wpforms-4771-field_9-description\" ><\/textarea><div id=\"wpforms-4771-field_9-description\" class=\"wpforms-field-description\"> If you don't know, you can leave this empty. <\/div><\/div><div id=\"wpforms-4771-field_28-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_28\">On a scale from 1 to 10, how strong is your anxiety lately? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_28\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][28]\" aria-errormessage=\"wpforms-4771-field_28-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_10-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_10\">Tell me about how anxiety is impacting your life (daily life, relations, work, achieving projects and dreams...).  What consequences of this excessive anxiety do you see in your life? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_10\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][10]\" aria-errormessage=\"wpforms-4771-field_10-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_29-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_29\">Do you know how your anxiety gets triggered? Please share some examples. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_29\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][29]\" aria-errormessage=\"wpforms-4771-field_29-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_30-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_30\">What have you already done and maybe still doing to try to decrease your anxiety (ex: practices, therapy, meds, diet changes, supplements etc)?  Please comment about any successful or unsuccessful experiences. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_30\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][30]\" aria-errormessage=\"wpforms-4771-field_30-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_31-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"31\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_31\">Anxiety is often being associated with other things... Please let me know if you have (or suspect to have) any mental and\/or personality disorder (autism, ADHD, depression, OCD...). <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_31\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][31]\" aria-errormessage=\"wpforms-4771-field_31-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_32-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_32\">At the moment, do you take any medications and\/or supplements? If yes, please list them below. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_32\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][32]\" aria-errormessage=\"wpforms-4771-field_32-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_33-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"33\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_33\">Are you currently seeing a therapist\/psychologist\/psychiatrist right now? If so, please share your reason(s)? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_33\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][33]\" aria-errormessage=\"wpforms-4771-field_33-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_82-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"82\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_82\">Anxiety can have roots in our body&#039;s condition. Do you have any physical disease or chronic symptoms? How are your periods (regular or not, heavy or light...)? Do you know if your hormones are balanced? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_82\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][82]\" aria-errormessage=\"wpforms-4771-field_82-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_34-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"34\"><fieldset><legend class=\"wpforms-field-label\">3. ABOUT LIFECALMA COACHING: Could you commit mentally, emotionally and financially for an intense coaching program, for at least 3 months? -After these first 3 months, the coaching can be lighter- <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-4771-field_34\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_34_1\" name=\"wpforms[fields][34][]\" value=\"Yes\" aria-errormessage=\"wpforms-4771-field_34_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_34_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_34_2\" name=\"wpforms[fields][34][]\" value=\"Not sure\" aria-errormessage=\"wpforms-4771-field_34_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_34_2\">Not sure<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-4771-field_12-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_12\">Describe your main motivation and goal(s) for this Coaching. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_12\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][12]\" aria-errormessage=\"wpforms-4771-field_12-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_64-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"64\"><div id=\"wpforms-4771-field_64\" class=\"wpforms-field-medium wpforms-field-row\" aria-errormessage=\"wpforms-4771-field_64-error\"><div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-4771-field_57-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"57\"><label class=\"wpforms-field-label\">Psychology <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_57_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_57_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][57]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_57-error\" aria-describedby=\"wpforms-4771-field_57-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_57_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_57_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][57]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_57-error\" aria-describedby=\"wpforms-4771-field_57-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_57_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_57_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][57]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_57-error\" aria-describedby=\"wpforms-4771-field_57-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_57_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_57_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][57]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_57-error\" aria-describedby=\"wpforms-4771-field_57-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_57_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_57_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][57]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_57-error\" aria-describedby=\"wpforms-4771-field_57-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div><div id=\"wpforms-4771-field_57-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div><\/div><div id=\"wpforms-4771-field_58-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"58\"><label class=\"wpforms-field-label\">Breathing <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_58_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_58_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][58]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_58-error\" aria-describedby=\"wpforms-4771-field_58-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_58_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_58_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][58]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_58-error\" aria-describedby=\"wpforms-4771-field_58-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_58_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_58_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][58]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_58-error\" aria-describedby=\"wpforms-4771-field_58-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_58_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_58_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][58]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_58-error\" aria-describedby=\"wpforms-4771-field_58-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_58_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_58_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][58]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_58-error\" aria-describedby=\"wpforms-4771-field_58-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div><div id=\"wpforms-4771-field_58-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div><\/div><div id=\"wpforms-4771-field_59-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"59\"><label class=\"wpforms-field-label\">Spirituality <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_59_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_59_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][59]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_59-error\" aria-describedby=\"wpforms-4771-field_59-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_59_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_59_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][59]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_59-error\" aria-describedby=\"wpforms-4771-field_59-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_59_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_59_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][59]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_59-error\" aria-describedby=\"wpforms-4771-field_59-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_59_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_59_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][59]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_59-error\" aria-describedby=\"wpforms-4771-field_59-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_59_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_59_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][59]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_59-error\" aria-describedby=\"wpforms-4771-field_59-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div><div id=\"wpforms-4771-field_59-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div><\/div><div id=\"wpforms-4771-field_60-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"60\"><label class=\"wpforms-field-label\">Naturopathy (natural practices and art, music-therapy) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_60_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_60_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][60]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_60-error\" aria-describedby=\"wpforms-4771-field_60-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_60_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_60_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][60]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_60-error\" aria-describedby=\"wpforms-4771-field_60-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_60_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_60_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][60]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_60-error\" aria-describedby=\"wpforms-4771-field_60-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_60_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_60_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][60]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_60-error\" aria-describedby=\"wpforms-4771-field_60-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_60_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_60_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][60]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_60-error\" aria-describedby=\"wpforms-4771-field_60-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div><div id=\"wpforms-4771-field_60-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div><\/div><div id=\"wpforms-4771-field_61-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"61\"><label class=\"wpforms-field-label\">Body Moves <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_61_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_61_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][61]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_61-error\" aria-describedby=\"wpforms-4771-field_61-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_61_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_61_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][61]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_61-error\" aria-describedby=\"wpforms-4771-field_61-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_61_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_61_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][61]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_61-error\" aria-describedby=\"wpforms-4771-field_61-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_61_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_61_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][61]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_61-error\" aria-describedby=\"wpforms-4771-field_61-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_61_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_61_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][61]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_61-error\" aria-describedby=\"wpforms-4771-field_61-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div><div id=\"wpforms-4771-field_61-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div><\/div><div id=\"wpforms-4771-field_62-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"62\"><label class=\"wpforms-field-label\">Nutrition &amp; Supplements <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_62_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_62_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][62]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_62-error\" aria-describedby=\"wpforms-4771-field_62-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_62_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_62_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][62]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_62-error\" aria-describedby=\"wpforms-4771-field_62-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_62_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_62_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][62]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_62-error\" aria-describedby=\"wpforms-4771-field_62-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_62_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_62_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][62]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_62-error\" aria-describedby=\"wpforms-4771-field_62-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_62_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_62_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][62]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_62-error\" aria-describedby=\"wpforms-4771-field_62-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div><div id=\"wpforms-4771-field_62-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div><\/div><div id=\"wpforms-4771-field_47-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"47\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_47\">Do you have any questions about one or more of these six categories in LifeCalma&#039;s Coaching? (optional)<\/label><textarea id=\"wpforms-4771-field_47\" class=\"wpforms-field-medium\" name=\"wpforms[fields][47]\" aria-errormessage=\"wpforms-4771-field_47-error\" ><\/textarea><\/div><div id=\"wpforms-4771-field_79-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"79\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_79\">Do you think you have already a good knowledge and experiences in one or more fields?  LifeCalma&#039;s 6 fields: Psychology, Breathing, Spirituality, Naturopathy, BodyMoves, Nutrition.  Please elaborate (optional).  <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_79\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][79]\" aria-errormessage=\"wpforms-4771-field_79-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_14-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_14\">Nutrition is an essential part of how our nervous system and brain work.  At the moment, do you follow a particular diet? If so, please name it or describe it. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_14\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][14]\" aria-errormessage=\"wpforms-4771-field_14-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_46-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"46\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_46\">I will suggest you various exercises and ideas to improve your anxiety, in each of the 6 categories. Most are free, though some have a cost.  For best results, it&#039;s important to have the capacity to invest in for example: supplements, various health tests...  Is your budget narrow, or would it allow for extra costs? Please elaborate. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_46\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][46]\" aria-errormessage=\"wpforms-4771-field_46-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_20-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_20\">4. YOUR PERSONALITY and IMAGINATION: How would you describe your personality as a child (before 8 years old)? -in some words or few sentences- <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_20\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][20]\" aria-errormessage=\"wpforms-4771-field_20-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_49-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"49\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_49\">How would you describe your personality now?  -in some words or few sentences- <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_49\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][49]\" aria-errormessage=\"wpforms-4771-field_49-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_50-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"50\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_50\">Have you observed your senses being more developed than average, or easier to feel over stimulated (audition, visual...)?  <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_50\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][50]\" aria-errormessage=\"wpforms-4771-field_50-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_52-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"52\"><fieldset><legend class=\"wpforms-field-label\">Do you consider yourself: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-4771-field_52\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_1\" name=\"wpforms[fields][52][]\" value=\"overly organized\" aria-errormessage=\"wpforms-4771-field_52_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_1\">overly organized<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_2\" name=\"wpforms[fields][52][]\" value=\"very well organized\" aria-errormessage=\"wpforms-4771-field_52_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_2\">very well organized<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_3\" name=\"wpforms[fields][52][]\" value=\"organized enough\" aria-errormessage=\"wpforms-4771-field_52_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_3\">organized enough<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_4\" name=\"wpforms[fields][52][]\" value=\"organized and disorganized (depending subjects, moments...)\" aria-errormessage=\"wpforms-4771-field_52_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_4\">organized and disorganized (depending subjects, moments...)<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_5\" name=\"wpforms[fields][52][]\" value=\"disorganized but manageable\" aria-errormessage=\"wpforms-4771-field_52_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_5\">disorganized but manageable<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_7\" name=\"wpforms[fields][52][]\" value=\"chaotic and it&#039;s a struggle\" aria-errormessage=\"wpforms-4771-field_52_7-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_7\">chaotic and it's a struggle<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-4771-field_51-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"51\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_51\">Do you often procrastinate on important things? If so, please share one or two examples. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_51\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][51]\" aria-errormessage=\"wpforms-4771-field_51-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_53-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"53\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_53\">Do you consider yourself a perfectionist? If so, please share one or two examples. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_53\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][53]\" aria-errormessage=\"wpforms-4771-field_53-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_54-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"54\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_54\">If you could talk to your anxiety... What would you tell her right now?! <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_54\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][54]\" aria-errormessage=\"wpforms-4771-field_54-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_55-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"55\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_55\">If i gave you a tennis ball right now. Besides playing tennis, what else would you do with it?  Be creative and descriptive! Up to 5 ideas of other uses for the tennis ball are welcome. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_55\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][55]\" aria-errormessage=\"wpforms-4771-field_55-error\" required><\/textarea><\/div><div id=\"wpforms-4771-field_80-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"80\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_80\">5. CLOSURE: Use this space to add anything else you consider relevant for me to know (optional).<\/label><textarea id=\"wpforms-4771-field_80\" class=\"wpforms-field-medium\" name=\"wpforms[fields][80]\" aria-errormessage=\"wpforms-4771-field_80-error\" ><\/textarea><\/div><div id=\"wpforms-4771-field_66-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"66\"><div id=\"wpforms-4771-field_66\" class=\"wpforms-field-medium wpforms-field-row\" aria-errormessage=\"wpforms-4771-field_66-error\"><p>Thank you for your time and energy!<br \/>\nYou will get a message shortly after i receive your answers.<\/p>\n<p><img decoding=\"async\" height=\"400\" width=\"752\" alt=\"\" src=\"https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS.avif\" class=\"aligncenter size-full wp-image-5475\" srcset=\"https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS-200x106.avif 200w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS-300x160.avif 300w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS-400x213.avif 400w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS-600x319.avif 600w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS.avif 752w\" sizes=\"(max-width: 752px) 100vw, 752px\" \/><\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"4771\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/lifecalma.com\/index.php\/wp-json\/wp\/v2\/pages\/4783\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-4771\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Send\" aria-live=\"assertive\" value=\"wpforms-submit\">Send<\/button><img decoding=\"async\" src=\"https:\/\/lifecalma.com\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-blend:overlay;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-2\"><p><style id=\"wpforms-css-vars-root\">\n\t\t\t\t:root \n\t\t\t<\/style>\n<div class=\"wpforms-container wpforms-container-full wpforms-block wpforms-block-a26031a0-0608-46c4-a7e9-afe3c477884d wpforms-render-modern\" id=\"wpforms-4771\">\n<form id=\"wpforms-form-4771\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"4771\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php\/wp-json\/wp\/v2\/pages\/4783\" data-token=\"2cbdb1ec6274dcebb9d358f16e2090d9\" data-token-time=\"1782161513\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><\/p>\n<div class=\"wpforms-hidden\" id=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/div>\n<div class=\"wpforms-field-container\">\n<div id=\"wpforms-4771-field_67-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"67\">\n<div id=\"wpforms-4771-field_67\" class=\"wpforms-field-medium wpforms-field-row\" aria-errormessage=\"wpforms-4771-field_67-error\">\n<p><img decoding=\"async\" height=\"400\" width=\"752\" alt=\"\" src=\"https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST.avif\" class=\"aligncenter size-full wp-image-5473\" srcset=\"https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST-200x106.avif 200w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST-300x160.avif 300w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST-400x213.avif 400w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST-600x319.avif 600w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/QUEST.avif 752w\" sizes=\"(max-width: 752px) 100vw, 752px\" \/><\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div>\n<\/div>\n<\/div>\n<div id=\"wpforms-4771-field_78-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"78\">\n<h3 id=\"wpforms-4771-field_78\" aria-errormessage=\"wpforms-4771-field_78-error\">GENERAL INFO<\/h3>\n<\/div>\n<div id=\"wpforms-4771-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\">\n<fieldset>\n<legend class=\"wpforms-field-label\">1. GENERAL INFO: Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend>\n<div class=\"wpforms-field-row wpforms-field-medium\">\n<div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-4771-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" aria-errormessage=\"wpforms-4771-field_0-error\" required><label for=\"wpforms-4771-field_0\" class=\"wpforms-field-sublabel after\">First<\/label><\/div>\n<div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-4771-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" aria-errormessage=\"wpforms-4771-field_0-last-error\" required><label for=\"wpforms-4771-field_0-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div>\n<\/div>\n<\/fieldset>\n<\/div>\n<div id=\"wpforms-4771-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_1\">Country and State of residence? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-4771-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" spellcheck=\"false\" aria-errormessage=\"wpforms-4771-field_1-error\" required><\/div>\n<div id=\"wpforms-4771-field_24-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"24\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_24\">Age <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-4771-field_24\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][24]\" spellcheck=\"false\" aria-errormessage=\"wpforms-4771-field_24-error\" required><\/div>\n<div id=\"wpforms-4771-field_25-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_25\">Marital status, Children (ages, if any). <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-4771-field_25\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][25]\" spellcheck=\"false\" aria-errormessage=\"wpforms-4771-field_25-error\" aria-describedby=\"wpforms-4771-field_25-description\" required><\/p>\n<div id=\"wpforms-4771-field_25-description\" class=\"wpforms-field-description\">This will help me understand your close environment.<\/div>\n<\/div>\n<div id=\"wpforms-4771-field_8-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_8\">2. QUESTIONS ABOUT YOUR ANXIETY: How long have you been suffering from anxiety? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_8\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][8]\" aria-errormessage=\"wpforms-4771-field_8-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_9-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_9\">What type(s) of anxiety are you suffering from (social, generalized etc)? Please let me know if you have been diagnosed with anxiety or if it's a self report (both are ok for me).<\/label><textarea id=\"wpforms-4771-field_9\" class=\"wpforms-field-small\" name=\"wpforms[fields][9]\" aria-errormessage=\"wpforms-4771-field_9-error\" aria-describedby=\"wpforms-4771-field_9-description\" ><\/textarea><\/p>\n<div id=\"wpforms-4771-field_9-description\" class=\"wpforms-field-description\"> If you don't know, you can leave this empty. <\/div>\n<\/div>\n<div id=\"wpforms-4771-field_28-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_28\">On a scale from 1 to 10, how strong is your anxiety lately? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_28\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][28]\" aria-errormessage=\"wpforms-4771-field_28-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_10-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_10\">Tell me about how anxiety is impacting your life (daily life, relations, work, achieving projects and dreams\u2026).  What consequences of this excessive anxiety do you see in your life? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_10\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][10]\" aria-errormessage=\"wpforms-4771-field_10-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_29-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_29\">Do you know how your anxiety gets triggered? Please share some examples. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_29\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][29]\" aria-errormessage=\"wpforms-4771-field_29-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_30-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_30\">What have you already done and maybe still doing to try to decrease your anxiety (ex: practices, therapy, meds, diet changes, supplements etc)?  Please comment about any successful or unsuccessful experiences. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_30\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][30]\" aria-errormessage=\"wpforms-4771-field_30-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_31-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"31\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_31\">Anxiety is often being associated with other things\u2026 Please let me know if you have (or suspect to have) any mental and\/or personality disorder (autism, ADHD, depression, OCD\u2026). <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_31\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][31]\" aria-errormessage=\"wpforms-4771-field_31-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_32-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_32\">At the moment, do you take any medications and\/or supplements? If yes, please list them below. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_32\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][32]\" aria-errormessage=\"wpforms-4771-field_32-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_33-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"33\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_33\">Are you currently seeing a therapist\/psychologist\/psychiatrist right now? If so, please share your reason(s)? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_33\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][33]\" aria-errormessage=\"wpforms-4771-field_33-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_82-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"82\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_82\">Anxiety can have roots in our body's condition. Do you have any physical disease or chronic symptoms? How are your periods (regular or not, heavy or light\u2026)? Do you know if your hormones are balanced? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_82\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][82]\" aria-errormessage=\"wpforms-4771-field_82-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_34-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"34\">\n<fieldset>\n<legend class=\"wpforms-field-label\">3. ABOUT LIFECALMA COACHING: Could you commit mentally, emotionally and financially for an intense coaching program, for at least 3 months? -After these first 3 months, the coaching can be lighter- <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend>\n<ul id=\"wpforms-4771-field_34\" class=\"wpforms-field-required\">\n<li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_34_1\" name=\"wpforms[fields][34][]\" value=\"Yes\" aria-errormessage=\"wpforms-4771-field_34_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_34_1\">Yes<\/label><\/li>\n<li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_34_2\" name=\"wpforms[fields][34][]\" value=\"Not sure\" aria-errormessage=\"wpforms-4771-field_34_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_34_2\">Not sure<\/label><\/li>\n<\/ul>\n<\/fieldset>\n<\/div>\n<div id=\"wpforms-4771-field_12-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_12\">Describe your main motivation and goal(s) for this Coaching. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_12\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][12]\" aria-errormessage=\"wpforms-4771-field_12-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_64-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"64\">\n<div id=\"wpforms-4771-field_64\" class=\"wpforms-field-medium wpforms-field-row\" aria-errormessage=\"wpforms-4771-field_64-error\">\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div>\n<\/div>\n<\/div>\n<div id=\"wpforms-4771-field_57-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"57\"><label class=\"wpforms-field-label\">Psychology <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><\/p>\n<div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_57_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_57_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][57]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_57-error\" aria-describedby=\"wpforms-4771-field_57-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_57_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_57_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][57]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_57-error\" aria-describedby=\"wpforms-4771-field_57-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_57_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_57_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][57]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_57-error\" aria-describedby=\"wpforms-4771-field_57-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_57_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_57_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][57]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_57-error\" aria-describedby=\"wpforms-4771-field_57-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_57_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_57_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][57]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_57-error\" aria-describedby=\"wpforms-4771-field_57-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div>\n<div id=\"wpforms-4771-field_57-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div>\n<\/div>\n<div id=\"wpforms-4771-field_58-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"58\"><label class=\"wpforms-field-label\">Breathing <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><\/p>\n<div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_58_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_58_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][58]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_58-error\" aria-describedby=\"wpforms-4771-field_58-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_58_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_58_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][58]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_58-error\" aria-describedby=\"wpforms-4771-field_58-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_58_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_58_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][58]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_58-error\" aria-describedby=\"wpforms-4771-field_58-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_58_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_58_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][58]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_58-error\" aria-describedby=\"wpforms-4771-field_58-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_58_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_58_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][58]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_58-error\" aria-describedby=\"wpforms-4771-field_58-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div>\n<div id=\"wpforms-4771-field_58-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div>\n<\/div>\n<div id=\"wpforms-4771-field_59-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"59\"><label class=\"wpforms-field-label\">Spirituality <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><\/p>\n<div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_59_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_59_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][59]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_59-error\" aria-describedby=\"wpforms-4771-field_59-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_59_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_59_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][59]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_59-error\" aria-describedby=\"wpforms-4771-field_59-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_59_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_59_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][59]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_59-error\" aria-describedby=\"wpforms-4771-field_59-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_59_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_59_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][59]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_59-error\" aria-describedby=\"wpforms-4771-field_59-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_59_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_59_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][59]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_59-error\" aria-describedby=\"wpforms-4771-field_59-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div>\n<div id=\"wpforms-4771-field_59-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div>\n<\/div>\n<div id=\"wpforms-4771-field_60-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"60\"><label class=\"wpforms-field-label\">Naturopathy (natural practices and art, music-therapy) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><\/p>\n<div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_60_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_60_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][60]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_60-error\" aria-describedby=\"wpforms-4771-field_60-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_60_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_60_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][60]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_60-error\" aria-describedby=\"wpforms-4771-field_60-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_60_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_60_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][60]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_60-error\" aria-describedby=\"wpforms-4771-field_60-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_60_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_60_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][60]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_60-error\" aria-describedby=\"wpforms-4771-field_60-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_60_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_60_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][60]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_60-error\" aria-describedby=\"wpforms-4771-field_60-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div>\n<div id=\"wpforms-4771-field_60-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div>\n<\/div>\n<div id=\"wpforms-4771-field_61-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"61\"><label class=\"wpforms-field-label\">Body Moves <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><\/p>\n<div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_61_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_61_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][61]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_61-error\" aria-describedby=\"wpforms-4771-field_61-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_61_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_61_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][61]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_61-error\" aria-describedby=\"wpforms-4771-field_61-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_61_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_61_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][61]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_61-error\" aria-describedby=\"wpforms-4771-field_61-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_61_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_61_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][61]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_61-error\" aria-describedby=\"wpforms-4771-field_61-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_61_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_61_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][61]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_61-error\" aria-describedby=\"wpforms-4771-field_61-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div>\n<div id=\"wpforms-4771-field_61-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div>\n<\/div>\n<div id=\"wpforms-4771-field_62-container\" class=\"wpforms-field wpforms-field-rating\" data-field-id=\"62\"><label class=\"wpforms-field-label\">Nutrition & Supplements <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><\/p>\n<div class=\"wpforms-field-rating-items\"><label class=\"wpforms-field-rating-item choice-1\" for=\"wpforms-4771-field_62_1\"><span class=\"wpforms-screen-reader-element\">Rate 1 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_62_1\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][62]\" value=\"1\" aria-errormessage=\"wpforms-4771-field_62-error\" aria-describedby=\"wpforms-4771-field_62-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-2\" for=\"wpforms-4771-field_62_2\"><span class=\"wpforms-screen-reader-element\">Rate 2 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_62_2\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][62]\" value=\"2\" aria-errormessage=\"wpforms-4771-field_62-error\" aria-describedby=\"wpforms-4771-field_62-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-3\" for=\"wpforms-4771-field_62_3\"><span class=\"wpforms-screen-reader-element\">Rate 3 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_62_3\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][62]\" value=\"3\" aria-errormessage=\"wpforms-4771-field_62-error\" aria-describedby=\"wpforms-4771-field_62-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-4\" for=\"wpforms-4771-field_62_4\"><span class=\"wpforms-screen-reader-element\">Rate 4 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_62_4\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][62]\" value=\"4\" aria-errormessage=\"wpforms-4771-field_62-error\" aria-describedby=\"wpforms-4771-field_62-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><label class=\"wpforms-field-rating-item choice-5\" for=\"wpforms-4771-field_62_5\"><span class=\"wpforms-screen-reader-element\">Rate 5 out of 5<\/span><input type=\"radio\" id=\"wpforms-4771-field_62_5\" class=\"wpforms-field-required wpforms-screen-reader-element\" name=\"wpforms[fields][62]\" value=\"5\" aria-errormessage=\"wpforms-4771-field_62-error\" aria-describedby=\"wpforms-4771-field_62-description\" required><svg width=\"24\" height=\"24\" style=\"height:24px;width:24px;\" fill=\"currentColor\" color=\"#066aab\" viewBox=\"0 0 1792 1792\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M1728 647q0 22-26 48l-363 354 86 500q1 7 1 20 0 21-10.5 35.5t-30.5 14.5q-19 0-40-12l-449-236-449 236q-22 12-40 12-21 0-31.5-14.5t-10.5-35.5q0-6 2-20l86-500-364-354q-25-27-25-48 0-37 56-46l502-73 225-455q19-41 49-41t49 41l225 455 502 73q56 9 56 46z\"\/><\/svg><\/label><\/div>\n<div id=\"wpforms-4771-field_62-description\" class=\"wpforms-field-description\">Please select your level of interest for this field of LifeCalma's Coaching<\/div>\n<\/div>\n<div id=\"wpforms-4771-field_47-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"47\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_47\">Do you have any questions about one or more of these six categories in LifeCalma's Coaching? (optional)<\/label><textarea id=\"wpforms-4771-field_47\" class=\"wpforms-field-medium\" name=\"wpforms[fields][47]\" aria-errormessage=\"wpforms-4771-field_47-error\" ><\/textarea><\/div>\n<div id=\"wpforms-4771-field_79-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"79\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_79\">Do you think you have already a good knowledge and experiences in one or more fields?  LifeCalma's 6 fields: Psychology, Breathing, Spirituality, Naturopathy, BodyMoves, Nutrition.  Please elaborate (optional).  <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_79\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][79]\" aria-errormessage=\"wpforms-4771-field_79-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_14-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_14\">Nutrition is an essential part of how our nervous system and brain work.  At the moment, do you follow a particular diet? If so, please name it or describe it. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_14\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][14]\" aria-errormessage=\"wpforms-4771-field_14-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_46-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"46\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_46\">I will suggest you various exercises and ideas to improve your anxiety, in each of the 6 categories. Most are free, though some have a cost.  For best results, it's important to have the capacity to invest in for example: supplements, various health tests\u2026  Is your budget narrow, or would it allow for extra costs? Please elaborate. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_46\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][46]\" aria-errormessage=\"wpforms-4771-field_46-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_20-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_20\">4. YOUR PERSONALITY and IMAGINATION: How would you describe your personality as a child (before 8 years old)? -in some words or few sentences- <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_20\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][20]\" aria-errormessage=\"wpforms-4771-field_20-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_49-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"49\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_49\">How would you describe your personality now?  -in some words or few sentences- <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_49\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][49]\" aria-errormessage=\"wpforms-4771-field_49-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_50-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"50\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_50\">Have you observed your senses being more developed than average, or easier to feel over stimulated (audition, visual\u2026)?  <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_50\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][50]\" aria-errormessage=\"wpforms-4771-field_50-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_52-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"52\">\n<fieldset>\n<legend class=\"wpforms-field-label\">Do you consider yourself: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend>\n<ul id=\"wpforms-4771-field_52\" class=\"wpforms-field-required\">\n<li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_1\" name=\"wpforms[fields][52][]\" value=\"overly organized\" aria-errormessage=\"wpforms-4771-field_52_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_1\">overly organized<\/label><\/li>\n<li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_2\" name=\"wpforms[fields][52][]\" value=\"very well organized\" aria-errormessage=\"wpforms-4771-field_52_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_2\">very well organized<\/label><\/li>\n<li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_3\" name=\"wpforms[fields][52][]\" value=\"organized enough\" aria-errormessage=\"wpforms-4771-field_52_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_3\">organized enough<\/label><\/li>\n<li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_4\" name=\"wpforms[fields][52][]\" value=\"organized and disorganized (depending subjects, moments...)\" aria-errormessage=\"wpforms-4771-field_52_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_4\">organized and disorganized (depending subjects, moments\u2026)<\/label><\/li>\n<li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_5\" name=\"wpforms[fields][52][]\" value=\"disorganized but manageable\" aria-errormessage=\"wpforms-4771-field_52_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_5\">disorganized but manageable<\/label><\/li>\n<li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-4771-field_52_7\" name=\"wpforms[fields][52][]\" value=\"chaotic and it's a struggle\" aria-errormessage=\"wpforms-4771-field_52_7-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4771-field_52_7\">chaotic and it's a struggle<\/label><\/li>\n<\/ul>\n<\/fieldset>\n<\/div>\n<div id=\"wpforms-4771-field_51-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"51\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_51\">Do you often procrastinate on important things? If so, please share one or two examples. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_51\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][51]\" aria-errormessage=\"wpforms-4771-field_51-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_53-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"53\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_53\">Do you consider yourself a perfectionist? If so, please share one or two examples. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_53\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][53]\" aria-errormessage=\"wpforms-4771-field_53-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_54-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"54\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_54\">If you could talk to your anxiety\u2026 What would you tell her right now?! <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_54\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][54]\" aria-errormessage=\"wpforms-4771-field_54-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_55-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"55\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_55\">If i gave you a tennis ball right now. Besides playing tennis, what else would you do with it?  Be creative and descriptive! Up to 5 ideas of other uses for the tennis ball are welcome. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-4771-field_55\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][55]\" aria-errormessage=\"wpforms-4771-field_55-error\" required><\/textarea><\/div>\n<div id=\"wpforms-4771-field_80-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"80\"><label class=\"wpforms-field-label\" for=\"wpforms-4771-field_80\">5. CLOSURE: Use this space to add anything else you consider relevant for me to know (optional).<\/label><textarea id=\"wpforms-4771-field_80\" class=\"wpforms-field-medium\" name=\"wpforms[fields][80]\" aria-errormessage=\"wpforms-4771-field_80-error\" ><\/textarea><\/div>\n<div id=\"wpforms-4771-field_66-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"66\">\n<div id=\"wpforms-4771-field_66\" class=\"wpforms-field-medium wpforms-field-row\" aria-errormessage=\"wpforms-4771-field_66-error\">\n<p>Thank you for your time and energy!<br \/>\nYou will get a message shortly after i receive your answers.<\/p>\n<p><img decoding=\"async\" height=\"400\" width=\"752\" alt=\"\" src=\"https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS.avif\" class=\"aligncenter size-full wp-image-5475\" srcset=\"https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS-200x106.avif 200w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS-300x160.avif 300w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS-400x213.avif 400w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS-600x319.avif 600w, https:\/\/lifecalma.com\/wp-content\/uploads\/2024\/09\/THANKS.avif 752w\" sizes=\"(max-width: 752px) 100vw, 752px\" \/><\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<p><!-- .wpforms-field-container --><\/p>\n<div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"4771\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/lifecalma.com\/index.php\/wp-json\/wp\/v2\/pages\/4783\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-4771\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Send\" aria-live=\"assertive\" value=\"wpforms-submit\">Send<\/button><img decoding=\"async\" src=\"https:\/\/lifecalma.com\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div>\n<\/form>\n<\/div>\n<p>  <!-- .wpforms-container --><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-4783","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Questionnaire | LifeCalma<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/lifecalma.com\/index.php\/questionnaire\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Questionnaire | LifeCalma\" \/>\n<meta property=\"og:url\" content=\"https:\/\/lifecalma.com\/index.php\/questionnaire\/\" \/>\n<meta property=\"og:site_name\" content=\"LifeCalma\" \/>\n<meta property=\"article:modified_time\" content=\"2024-10-06T16:55:17+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/lifecalma.com\\\/index.php\\\/questionnaire\\\/\",\"url\":\"https:\\\/\\\/lifecalma.com\\\/index.php\\\/questionnaire\\\/\",\"name\":\"Questionnaire | LifeCalma\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/lifecalma.com\\\/#website\"},\"datePublished\":\"2024-09-21T02:44:54+00:00\",\"dateModified\":\"2024-10-06T16:55:17+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/lifecalma.com\\\/index.php\\\/questionnaire\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/lifecalma.com\\\/index.php\\\/questionnaire\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/lifecalma.com\\\/index.php\\\/questionnaire\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/lifecalma.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Questionnaire\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/lifecalma.com\\\/#website\",\"url\":\"https:\\\/\\\/lifecalma.com\\\/\",\"name\":\"LifeCalma\",\"description\":\"Anxiety coaching for women by a woman. 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