5-Step Destiny Designer

Welcome to your Destiny Designer 5-Step Road Map.
 
These questions are intended to help you gain deep clarity on your goals and solidify your intentions for change.
 
You’re designing your future with every answer, so honor your life by allowing plenty of time to thoughtfully complete your road map. 
 
Set aside about 20 minutes to do this in one sitting as answers cannot be saved and returned to later.  
 
Enjoy, 
Christina Michelle
Welcome to your Destiny Designer 5-Step Road Map.
 
These questions are intended to help you gain deep clarity on your goals and solidify your intentions for change.
 
You’re designing your future with every answer, so honor your life by allowing plenty of time to thoughtfully complete your road map. 
 
Set aside about 20 minutes to do this in one sitting as answers cannot be saved and returned to later.  
 
Enjoy, 
Christina Michelle
Step 1 - Getting to Know You
First & Last Name:
Phone Number
 
Name I prefer to be called
If different from your first name
Date of Birth
Physical Address 
Provide your address if our hypnotherapy sessions will be over video calls. Should we get disconnected during a session and I cannot reach you afterwards, I will send a welfare check to your home. I've never had to do this, it's just a precaution.
Marital Status
Single
Married
Divorced
Widowed
Living with significant other
Occupation
Approximate Date of Last Medical Check Up
Medications Currently Prescribed
Check All Areas of Concern That Apply
Achieving Goals
Addiction
Anorexia
Anxiety
Bulimia
Bipolar Disorder
Career Issues
Childhood Problems
Compulsive Behavior
Concentration
Confidence
Depression
Drinking
Drugs
Eating Problems
Exams
Exercise
Motivation
Fears
Fertility
Food/Diet
Gambling
Guilt
Hallucinations
Hearing
Insomnia
Interview Skills
Memory
Nerves
Pain Control
Panic Attacks
Procrastination
PTSD
Public Speaking
Relationships
Relaxation
Schizophrenia
Self-Esteem
Sexual Problems
Other (please explain during our session)
Which one area, if fixed, would have the biggest impact on the others?
Physical & Mental Issues
Describe past and present. Enter n/a if none.
STEP 2 - Let's talk about the past for a minute...
I MOST CLOSELY identified with this role as a child
Care taker
Sick one
Rebel
Smart one
I still tend to play this role in my life as an adult
Yes
No
Sometimes
If so, how?
STEP 3 - Let's step into the present...
3 things that stop me in my tracks from being as confident as I want to be
3 fears I wish to overcome
3 things I'd love to call more of into my life
For the next few questions, rate your current satisfaction level.
1 = not satisfied at all
10 = extremely satisfied
On a scale of 1-10 I am this satisfied with my romantic life
This refers to how happy you are in your current state of relationship – whether you happily single, in a relationship, dating or desiring a relationship. 
1
2
3
4
5
6
7
8
9
10
On a scale of 1-10, I am this satisfied with my friendships
How strong a support network you have. Ideally at least 5 friends - outside of your family - who have your best interest at heart, and you love spending time with.
1
2
3
4
5
6
7
8
9
10
On a scale of 1-10, I am this satisfied with my self-care habits
Setting and sticking to boundaries, taking preventative and corrective action to protect your mental and physical health. Scheduling alone time, doing nice things for yourself, etc.
1
2
3
4
5
6
7
8
9
10
On a scale of 1-10 I'm this satisfied with my daily living environment
The quality of your home, your car, your work space and the general spaces where you spend your time.
1
2
3
4
5
6
7
8
9
10
On a scale of 1-10 I'm this satisfied with my health
How you rate your health, considering your age any medical conditions.
1
2
3
4
5
6
7
8
9
10
On a scale of 1-10 I'm this satisfied with my spiritual life
Quantity and quality of time devoted to prayer, meditative, or contemplative practices that keep you feeling connected, balanced and peaceful.
1
2
3
4
5
6
7
8
9
10
On a scale of 1-10 I'm this satisfied with my career
Do you enjoy what you do? Are you growing, excelling, progressing? If you have a business is it thriving?
1
2
3
4
5
6
7
8
9
10
On a scale of 1-10 I'm this satisfied with my family life
Your relationship with your partner, parents, siblings. If you don't have immediate family, rate your relationship with your inner circle - friends who have become like family & extended family
1
2
3
4
5
6
7
8
9
10
On a scale of 1-10 I'm this satisfied with my sex life
Are you comfortable with your body and your sexuality? Do you know what you need and feel free to ask for it and / or please yourself?
1
2
3
4
5
6
7
8
9
10
3 habits I know I need to release
3 habits I know I need to start
STEP 4 - What you look forward to...
5 qualities I want to be over the coming year
5 words that describe me at my highest and best self
You're doing great, now let's make some declarations about your future...
You're doing great, now let's make some declarations about your future...
Anything that comes after the words "I Am" is easily accepted by your subconscious mind and will eventually program you for new behavior that matches your new belief.
 
Next, write 10 positive I Am statements that relate to the results you want to see from your coaching and / or generally in your life. You might use some of your 5 characteristics you identified that you want to be over the coming year.
 
Remember to keep your I Am statements positive,
For example, a negative affirmation would be:
"I am not depressed" or "I am not afraid" 
vs.
Simply saying the word "depressed" or "afraid" forms the wrong image in your mind.  Re-frame that affirmation in positive by saying something like I am happy" or "I am brave"
This creates the right positive image in your mind when you say your affirmations.  
 
Give it a try!
Anything that comes after the words "I Am" is easily accepted by your subconscious mind and will eventually program you for new behavior that matches your new belief.
 
Next, write 10 positive I Am statements that relate to the results you want to see from your coaching and / or generally in your life. You might use some of your 5 characteristics you identified that you want to be over the coming year.
 
Remember to keep your I Am statements positive,
For example, a negative affirmation would be:
"I am not depressed" or "I am not afraid" 
vs.
Simply saying the word "depressed" or "afraid" forms the wrong image in your mind.  Re-frame that affirmation in positive by saying something like I am happy" or "I am brave"
This creates the right positive image in your mind when you say your affirmations.  
 
Give it a try!
My 10 Positive Affirmations 
Now, take a moment to write down your affirmations in a journal or on a piece of paper that you can hang somewhere and see it every day. Repetition is key!  
Then plan ahead by choosing the best time of day for you to review these.  Writing down a time will help you remember to say your affirmations every day.
*What I've seen work well is taking a picture of your affirmations and saving it in your phone, or setting a reminder in your phone to say your affirmations.  
Now, take a moment to write down your affirmations in a journal or on a piece of paper that you can hang somewhere and see it every day. Repetition is key!  
Then plan ahead by choosing the best time of day for you to review these.  Writing down a time will help you remember to say your affirmations every day.
*What I've seen work well is taking a picture of your affirmations and saving it in your phone, or setting a reminder in your phone to say your affirmations.  
A good time of day for me to say my affirmations is:
STEP 5 - Solidifying Your Commitment to Yourself
I am committed to my growth and promise myself that I will fully show up and go all out for my coaching and therapy sessions
Yes!
I will remember that growth takes time and be kind to myself throughout this process
Yes!
Last thing, I will rate myself 5 stars because, no matter where I am in my journey, I'm already a rock star!
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