DREAM Score: Start!

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IMPORTANT: Please Read

This is a comprehensive survey of your lifestyle to help you determine where you are in your 'wellness journey' and guide you towards a path of optimal health. There are approximately 85 questions and all will make you think. It is 100% FREE and there are no gimmicks or upsells (other than the book if it's something you want to delve deeper into certain topics).

The average time to complete this survey is 20 minutes and you will not be able to stop and resume the session another time. Please be sure to begin this questionniare when you will be able to complete it in one sitting, preferably in a quiet place. Also, if you are completing this on a mobile device (not recommended), please be mindful of the back arrows if you choose to review a previous question (only click the arrows within the GREEN bar). If you click the wrong one, it may take out of the form completely and require you to start over.

This is NOT your typical social media quick quiz that will tell you what kind of superhero or animal you are! The report will provide you with practical information that can impact the trajectory of your life, that is why there are so many questions. The results will serve as an indicator of your current health status, and if you're a parent raising children, it will serve as predictor of your kids’ future health and well-being. The report is best when used as a guide to walk you through the book, D.R.E.A.M. Wellness: The 5 Keys to Raising Kids for a Lifetime of Physical and Mental Health and assist you in areas where improvement is most needed.

Please read every question carefully and thoughtfully. Some questions have many choices that may require you to scroll down to see all options depending on the device you are using.

All of your answers will be kept 100% confidential and the assessement tool is built in a HIPAA compliant, well-encrypted platform. The report is password protected to prevent any breaches in privacy. No information disclosed in this survey will be released to family members, employers, law enforcement, teachers, clients or anyone without your permission. Please answer the questions as honestly as possible. Understand that if you do not answer the quesitons truthfully, you will miss the opportunity to learn more about yourself and what improvements are recommended.

As we are still in unusal times, many aspects of your current lifestyle may not be typical for you. Answer the questions based on your current situation, not based on your past habits or your future desires.

Have fun and we look forward to helping you live your DREAM, everyday!

To read our privacy policy, click here. For our medical, legal and affiliate disclaimers, click here.
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Name* This field is required.
First Name
Last Name
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Email Promise:* This field is required.
I am providing my email to receive the report, and I give permission to have information and promotions sent to me regarding my overall health and lifestyle. I am aware that I can opt out of future emails at any time.
I am providing my email only to receive a copy of my report, and for information related to the DREAM Score and the book. I am aware that I can opt out of future emails at any time.
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Email (preferably not Gmail if possible)* This field is required.Important! The results will be sent to you by email immediately upon completion. If you do not see the email in your Inbox, check your spam/junk/bulk mail folders (especially if you have a Gmail account). If you are using a Gmail account, it is very likely the email report will be blocked, but do not worry. Once you complete the questionnaire, there will be an opportunity to message us and let us know you didn't receive it and we will quickly send it manually. If you can use an email account that is not Gmail, that would be preferred.
example@example.com
Confirm Email
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Age (optional)
Don't worry, we won't tell anyone!
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Where in the world do you reside? Be as specific as you feel comfortable. (Optional)
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How did you learn about the DREAM Score?* This field is required.
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Are you a healthcare, fitness or other wellness professional?* This field is required.
YESNO
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Are you interested in possibly using this lifestyle assessment tool for your customers (patients, clients, students, etc...)?* This field is required.If you answer Yes or Probably, we will send you an application with information about our VIP (Valued Implementation Partner) Program. This program enables you to receive the detailed results and report that will also be sent directly to your patients/clients/customers; and you will be added to our directory with other healthcare, fitness and wellness professionals.
Yes, this sounds amazing!
Probably, but I need more information.
No thanks, not interested. I'm just taking the assessment for my personal use.
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Today's date* This field is required.
Date
Month
Day
Year
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Great! What do you do in health and wellness?Choose your licensed profession if applicable and your specialties if additional. Select all that apply
Medical Doctor / Osteopathic Doctor
Chiropractic Doctor
Acupuncturist
Naturopathic Doctor
Physical Therapist / DPT
Speech Therapist
Nurse Practitioner
Psychology / Psychiatry
Family Counseling
Functional Medicine / Functional Nutrition
Occupational Therapist
Holistic Health Practitioner
Clinical Nutrition
General lifestyle nutrition
Chinese Medicine / Oriental Medicine
Bodywork (all types including but not limited to massage, MLD, Rolfing/Structural Integration, Somatic work, Reiki, etc...)
Personal Training / Yoga / Pilates
Stretch therapy
Hypnotherapy
Aromatherapy / Essential Oils
Homeopathy
Naturopathy
Life Coach
Relationship Coach
General Health and Wellness Coach
Health & Beauty Products Advocate / Sales
Ayurvedic Practitioner
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