Name

Date

What time is this survey being filled out? What time is this survey being filled out?Before ChantAfter Chant

1 How do you feel your energy levels is at this time? 1 being no energy 10 being full 1 How do you feel your energy levels is at this time? 1 being no energy 10 being full 1 2 3 4 5 6 7 8 9 10

2 How often do you experience a positive mood: joy, peace, calm, happiness? 2 How often do you experience a positive mood: joy, peace, calm, happiness? 1 2 3 4 5 6 7 8 9 10

3 Do you feel much lighter in your body? 0 feels heavy 10 feels lighter/energetically 3 Do you feel much lighter in your body? 0 feels heavy 10 feels lighter/energetically 1 2 3 4 5 6 7 8 9 10

4 What is your stress level? 4 What is your stress level? 1 2 3 4 5 6 7 8 9 10

5 How well do you handle your stress? 1 not good 10 easy 5 How well do you handle your stress? 1 not good 10 easy 1 2 3 4 5 6 7 8 9 10

6 Do you feel a deep healing sleep, wake up feeling refreshed and relaxed? 6 Do you feel a deep healing sleep, wake up feeling refreshed and relaxed? 1 2 3 4 5 6 7 8 9 10

7 Do you feel more centered, and balanced? 1 not much 10 amazing 7 Do you feel more centered, and balanced? 1 not much 10 amazing 1 2 3 4 5 6 7 8 9 10

8 Does your day unfold effortlessly? 0 difficult 10 flowing easy 8 Does your day unfold effortlessly? 0 difficult 10 flowing easy 1 2 3 4 5 6 7 8 9 10

9 How grounded do you feel? 1 not able to focus/not being present 10 focused/being present 9 How grounded do you feel? 1 not able to focus/not being present 10 focused/being present 1 2 3 4 5 6 7 8 9 10

10 What’s your ability to heal in all levels physical, mental, & spiritual? 0 hardly 10 great 10 What’s your ability to heal in all levels physical, mental, & spiritual? 0 hardly 10 great 1 2 3 4 5 6 7 8 9 10

11 How does your energy field feel? 0 dirty/heavy 10 clean/light 11 How does your energy field feel? 0 dirty/heavy 10 clean/light 1 2 3 4 5 6 7 8 9 10

12 What is your conscious connection/level? 1 just starting 10 Buddha master 12 What is your conscious connection/level? 1 just starting 10 Buddha master 1 2 3 4 5 6 7 8 9 10

13 Do you feel more mental - alertness, clarity, focus, less/no mind chatter? 13 Do you feel more mental - alertness, clarity, focus, less/no mind chatter? 1 2 3 4 5 6 7 8 9 10

14 Do you feel hungry often or crave junk food, or stress eating? 14 Do you feel hungry often or crave junk food, or stress eating? 1 2 3 4 5 6 7 8 9 10

15 Do you feel an sense of power? 15 Do you feel an sense of power? 1 2 3 4 5 6 7 8 9 10

16 Do you feel in control of your life: effectively deal with difficult situations? 16 Do you feel in control of your life: effectively deal with difficult situations? 1 2 3 4 5 6 7 8 9 10

17 Do you feel productive? 17 Do you feel productive? 1 2 3 4 5 6 7 8 9 10

18 Do you feel creative? 18 Do you feel creative? 1 2 3 4 5 6 7 8 9 10

19 Do you feel the flow of synchronicity or miracles/magic in life? 19 Do you feel the flow of synchronicity or miracles/magic in life? 1 2 3 4 5 6 7 8 9 10

20 How do you feel your ability to create, attract and manifest in life daily? 20 How do you feel your ability to create, attract and manifest in life daily? 1 2 3 4 5 6 7 8 9 10

21 Do you feel body rejuvenation (bone healing, hair/nail growth etc.)? 21 Do you feel body rejuvenation (bone healing, hair/nail growth etc.)? 1 2 3 4 5 6 7 8 9 10

22 How efficient is your metabolism working for you? (Hungry after meditation) 22 How efficient is your metabolism working for you? (Hungry after meditation) 1 2 3 4 5 6 7 8 9 10

23 Ability to sense the invisibles? (beings/angels, soft incense smells) 23 Ability to sense the invisibles? (beings/angels, soft incense smells) 1 2 3 4 5 6 7 8 9 10

24 What is your ability level to relax? 24 What is your ability level to relax? 1 2 3 4 5 6 7 8 9 10

25 Do you feel fatigued and tired often? 25 Do you feel fatigued and tired often? 1 2 3 4 5 6 7 8 9 10

26 What is your current emotional state? 1 being calm 10 having extreme anxiety 26 What is your current emotional state? 1 being calm 10 having extreme anxiety 1 2 3 4 5 6 7 8 9 10

27 How flexible is your body? 27 How flexible is your body? 1 2 3 4 5 6 7 8 9 10

28 How adaptable are you in life situations? 28 How adaptable are you in life situations? 1 2 3 4 5 6 7 8 9 10

29 How burnt out are you? 1 burnt toast 10 feeling happy daily 29 How burnt out are you? 1 burnt toast 10 feeling happy daily 1 2 3 4 5 6 7 8 9 10

30 What is your experience during today’s meditation? Journal daily is highly encouraged 30 What is your experience during today’s meditation? Journal daily is highly encouraged 1 2 3 4 5 6 7 8 9 10

What was your experience during today’s meditation? Journal daily is highly encouraged

Any questions you'd like to add?