Qi Gong Questionnaire

Why Take This Qi Gong Questionnaire?

Qi Gong, an ancient South East Asian practice, offers a holistic approach to health and wellness. By understanding your current physical, mental, and emotional state, this questionnaire can help you determine if Qi Gong is a suitable practice for you. Whether you're seeking to improve your energy levels, reduce stress, or enhance your overall well-being, Qi Gong may be the key to unlocking your body's potential.

First Name *

Last Name *

Email *

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1. How would you describe your overall energy levels? *

I feel consistently energised and vibrant throughout the day

I have periods of energy, but often feel tired or sluggish

I frequently experience fatigue and lack of motivation

I feel chronically exhausted and drained

2. How often do you experience stress or anxiety *

I rarely experience stress or anxiety

I occasionally feel stressed or anxious, but it doesn't significantly impact my life

I often feel stressed or anxious, and it can be challenging to manage

I experience chronic stress and anxiety that significantly affects my daily life

3. How would you rate your physical flexibility and mobility? *

I am very flexible and have a wide range of motion

I am reasonably flexible and can move comfortably

I have some stiffness and limited flexibility

I experience significant stiffness and pain, limiting my mobility

4. How often do you experience physical pain or discomfort? *

I rarely experience any physical pain or discomfort

I occasionally experience minor aches and pains

I frequently experience moderate to severe pain or discomfort

I live with chronic pain that significantly impacts my quality of life

5. How would you describe your mental clarity and focus? *

I have excellent mental clarity and focus

I generally have good mental clarity, but sometimes struggle to focus

I often feel mentally foggy or have difficulty concentrating

I struggle with severe mental fog and difficulty focusing on tasks

6. How would you rate your overall sense of well-being? *

I feel a strong sense of overall well-being and contentment

I generally feel good, but sometimes experience negative emotions

I often feel down or unhappy, and struggle to find joy

I feel chronically depressed or anxious, and have difficulty enjoying life

7. How often do you practice mindfulness or meditation? *

I practice mindfulness or meditation regularly

I occasionally practice mindfulness or meditation

I rarely practice mindfulness or meditation

I have never practiced mindfulness or meditation

8. How would you describe your posture and alignment? *

I have excellent posture and alignment

I have good posture, but sometimes slouch

I often slouch and have poor posture

I have significant postural issues and chronic pain

9. How often do you engage in physical activity or exercise? *

I engage in regular, vigorous physical activity

I engage in moderate physical activity most days of the week

I rarely engage in physical activity or exercise

I am unable to engage in any physical activity or exercise

10. How would you describe your sleep quality? *

I sleep soundly and wake up feeling refreshed

I sleep well most nights, but sometimes have trouble falling asleep or staying asleep

I frequently experience insomnia or poor sleep quality

I have severe sleep problems that significantly impact my daily life