Name

Email Address

How is menopausal change impacting your life right now?

How do you feel about your body since beginning menopausal change?

Are any of your symptoms having an impact on your career, specifically which?

Are any of your symptoms affecting your relationships with a partner, family and/or friends, specifically which?

Are any of your symptoms having an impact on your social life and how?

How stressed would you say you were in general; not at all, moderately, quite a lot or I can’t take anymore?

How stressful is the menopause for you; 0-10, if ten is the worst?

What are you currently doing to help relieve your symptoms?

What hasn’t worked and why?

Would you say you’ve been self-soothing with comfort eating and drinking?

Do you typically self-soothe by shopping, lottery, substance misuse or other, which specifically?

What would you like help with; your body, your mental health (confidence/self-esteem/self-worth) or both?

Would you say you’re someone who gets things done or do you get easily distracted?

If your best friend were to describe you, the good and the not so good, what would they say?

If you were to describe yourself, the great and not so great, what would you say?

Is there any reason you can think of why you should keep on feeling the way you do?

How do you feel about your future? Do you feel you have purpose?

Have you buried any dreams/aspirations you may have once had because life got in the way?

Have you ever been told ‘You’re not good enough?’

Do you want to change how you look and feel?

What would you like your health, fitness and wellbeing to look and feel like?

Anything else you’d like to share?

How did you hear about NB-MenopauseMentor?