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Break the Cycle Questionnaire

Welcome!

I'm so excited you're joining me for Break the Cycle.

Before we begin, I'd love to learn a little more about you. This short questionnaire will help me better understand who is in the room, what challenges you're facing, and what you're hoping to achieve.

Your answers will help me tailor the training so it's as relevant, practical, and impactful as possible. There are no right or wrong answers—just be honest. The more open you are, the more value you'll receive from the experience.

Thank you for taking a few minutes to complete it. I can't wait to help you take the first step towards breaking the cycles that have been holding you back.

See you soon!

Polly

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Question 1 of 11

1. Which area of your life are you most wanting to break the cycle in right now?

(Select all that apply)
A

Business

B

Career

C

Money

D

Health

E

Relationships

F

Confidence & Self-Worth

G

Mindset

H

Other

Question 2 of 11

2. What is the biggest challenge you're currently facing in that area?

Question 3 of 11

3. How long have you been trying to create this change?

A

Less than 6 months

B

6–12 months

C

1–3 years

D

More than 3 years

Question 4 of 11

4. If nothing changes over the next 12 months, what concerns you the most?

Question 5 of 11

5. If everything went exactly as you hoped over the next 12 months, what would your life look like?

Question 6 of 11

6. What do you believe has been the biggest thing holding you back?

Question 7 of 11

7. How committed are you to creating lasting change?

A

I'm curious and seeing what's possible.

B

I'm ready to make some changes.

C

I'm fully committed and willing to do the work.

Question 8 of 11

8. Which best describes your current annual personal income (before tax)?

A

Under $75,000

B

$75,000–$100,000

C

$100,000–$150,000

D

$150,000–$250,000

E

$250,000–$500,000

F

Over $500,000

G

Prefer not to say

Question 9 of 11

9. What is one question you hope Polly answers during Break the Cycle?

Question 10 of 11

10. Finally... what made you decide to register for Break the Cycle today?

Question 11 of 11

If, after Break the Cycle, you feel ready to continue creating lasting change, would you like the opportunity to have a conversation with Polly or a member of her team to explore what the next step could look like?

A

Yes, I'd love that.

B

Maybe, depending on what I learn during the challenge.

C

Not at this stage.

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