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TONICS
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My Account
Cart
0
HOME
About
SERVICES
OVERVIEW
Sound Massage
Corporate Wellness
SOUND COACHING
SOUNDS
TONICS
Contact
Christin Rauter
Schedule Appointment
CONTACT
Christin Rauter
connect@thesoundnutritionist.com
FORMS
Sonic Questionnaire
Sonic Questionnaire
Name
*
First Name
Last Name
Email
*
This will help us craft your personal sonic tonics tailored to your unique needs and goals. Let’s begin!
How would you describe your daily energy levels?
*
high
fluctuating
low
How would you describe your current emotional state??
*
stressed
balanced
relaxed
content
depressed
restless
positive
active
isolated
anxious
angry
motivated
overwhelmed
Are there any emotions you’d like to cultivate more of?
joy
confidence
peace
Do you have issues?
*
sleeping
relaxing
focusing
being productive
motivating yourself
being active
being socialble
speaking in public
performing
communicating
being physically active
Which of these instruments do you like?
*
piano
guitar
cello
violin
orchestral strings
clarinet
flute
hang drum
trumpet
harp
Which of these music styles do you like?
*
Pop
Jazz
Blues
Rock
Hip Hop
Classical
Soul
Electronic
Country
Gregorian Chant
Which of these sounds do you like?
*
Ocean waves
Rainfall
Forest Ambience
Bird song
Wind through trees
Thunderstorm
Train
Whale or Dolphin Calls
Rustling leaves
Crackling fire
Are there any sounds you dislike or find distracting?
*
Are there any specific sounds you love that weren’t listed?
*
What is your primary goal for this sonic experience?
Focus
Relaxation
Better sleep
Reduce anxiety
Thank you for completing your Sonic Questionnaire! Your insights will guide us in creating a sound experience that resonates with your personal journey. Get ready to unlock the power of sound !
Thank you!
Self Reflection Form
Self reflection form
This brief self reflection exercise will help us to gain more clarity about your present state, vision and finding your intention. Let’s begin!
Name
*
First Name
Last Name
Email
*
1. What challenges do you face at the moment? What is most difficult for you right now?
2. What are your main goals for this process?
3. What emotions or feelings are you currently experiencing most often?
4. How do you typically cope with stress or overwhelm?
5. What brings you the most peace or balance in your life?
6. How aligned do you feel with your current goals or priorities?
7. What positive habits contribute to your emotional and mental well-being?
8. What area of your life feels most out of sync or unbalanced?
9. Briefly share your overall business and life goals. Where do you see yourself in….1 - 5 - 10 years
10. What intention would you like to set for this session?
11. How do you want to feel after this sound coaching experience?
Thank you for completing your self reflection form. These questions guide reflection on emotional states, intentions, and goals to maximize the impact of the session.
Thank you!
Client intake form
Client Intake Form
Name
*
First Name
Last Name
Date of birth
MM
DD
YYYY
Email
*
Phone
Prefered way to contact
email
phone
Emergency contact
(###)
###
####
Would you like to receive reminders during your program?
*
yes
no
I agree that I take the sessions at my own risk and responsibility regarding my health. And I don’t reproduce or resend all provided sound files to any other party.
*
I agree
Date
MM
DD
YYYY
Thank you!
Referal Program
