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Bali, Indonesia
Thailand
Sri Lanka
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Location
Koskanuwala Watta, Mahabage, Kithulgala, Sri Lanka.
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Contact Information
Address
Koskanuwala Watta, Mahabage, Kithulgala, Sri Lanka.
Phone
+ 94767993199
Phone 2
+94769783075
Email
info@palmstoneretreat.com
Website
https://www.palmstoneretreat.com/
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Application Form
1. Why are you interested in our weight loss program?
A) To improve my health and wellness
B) For a transformative life change
C) To learn about healthy living
D) Other (please specify)
2. What are your expectations from this program?
A) Significant weight loss
B) Learning new health habits
C) A relaxing wellness experience
D) A complete lifestyle change
3. Have you tried other weight loss methods before?
A) Yes, with great success
B) Yes, but with limited success
C) Yes, with no success
D) No, this is my first attempt
4. How do you handle stress and setbacks?
A) With optimism and resilience
B) I struggle but keep trying
C) I often get discouraged
D) I seek support from others
5. Describe your current lifestyle and dietary habits.
A) Active and health-conscious
B) Moderately active, trying to eat healthily
C) Sedentary with poor dietary choices
D) Other (please specify)
6. What does a successful weight loss journey look like to you?
A) Reaching a specific weight goal
B) Adopting lifelong healthy habits
C) Feeling happier and more energetic
D) All of the above
7. Are you open to trying new approaches to health and wellness?
A) Absolutely
B) Somewhat open
C) A bit hesitant
D) Not really
8. How do you define ‘fun’ and ‘happiness’ in the context of health and fitness?
A) Enjoying active pursuits
B) Feeling good mentally and physically
C) Achieving my fitness goals
D) Learning new health practices
E) All the above
9. Can you commit to the full duration of the program?
A) Yes, fully committed
B) Likely, but there may be challenges
C) Unsure at the moment
D) No, I have time constraints
10. Is there anything specific you hope to learn or achieve through this program?
A) Better nutritional knowledge
B) Effective exercise routines
C) Stress management techniques
D) All of the above
Please let us know about your specific needs.
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