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Shock Clock 2
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Step 1 of 12
What habit would you most like to change?
Over sleeping / Sleeping In
How in control do you feel when you eat?
1 (not at all)
How familiar are you with productivity techniques (goal setting, task list, check in with a coach, etc.)?
I've never really learned any
I've learned some but don't use them
I use tools weekly
I use tools daily
I'm a productivity monster
How much do you spend on smoking? (monthly)
Under $50 USD
$50 to $100
$100 to $200
How difficult do you find it to wake up in the morning?
1 (not at all)
How long have you been biting your nails?
1 to 3 years
4 to 9 years
10 to 19 years
20 years or more
How often do you have negative thoughts? (1 to 5 scale)
1 (not very)
5 (very often)
How often do you eat?
1 (only at meals)
5 (snack all day)
How often do you use a to-do list?
Hardly ever / never
Not very often
How many times have you tried to quit?
1 to 3
4 to 10
10 or more
What are the worst things that have happened to you because you've overslept?
Late to work
Slept through job interview
Slept through a test
Missed a flight
How often do you feel embarrassed about your nails?
At least a few times per month
A few times ar week
All the time
What are your negative thoughts accompanied by most?
Self pity or loathing
What foods do you have the most trouble with?
Chips / Pretzels
Soda / Sugary Drinks
How many hours weekly do you think you lost wasting time?
Less than 10
10 to 19
20 to 29
30 to 39
More than 40
How many years have you been a smoker?
Less than 3
3 to 5
5 to 10
10 to 20
More than 20
How often do you oversleep when you shouldn't?
Once a month or so
2 to 4 times a month
About twice a week
How do you think others judge your nail biting habit?
I never really thought about it
People don't really have an opinion
People think I look anxious or stressed
People think I don't have discipline or willpower
People think I have a nervous personality
What would your life be like without negative thoughts?
More work success
What reasons would you want to change your eating habits?
Have more energy
Improve overall health
Improve a specific condition
What reasons would you want to quit smoking?
Save more money / Have money to spend
What would it mean to you if you never overslept again?
I would have more time for things I cared about
I would have more job security
Receive a raise at work
My business would improve
People would view me as more reliable
People would stop thinking I was lazy
It would improve my relationships
I would be more alert and engaged in life
Have you ever tried to quit biting your nails?
Two or three times
When are your negative thoughts the heaviest?
Around other people
At my house
During my commute
Give us any details you'd like to provide about your habit.
On a scale from 1 to 5, how much would you benefit from having a Habit Coach?
1 (not at all)
5 (I NEED a coach to keep me on track)
Would you be interested in paying for a Pavlok Habit Coach?
Definitely, right away!!
Pavlok coaches help you set your goals, hold you accountable, and keep you on track. Choose yes if you're interested in having one reach out.
What's your name?
What are some questions you have about Pavlok / Shock Clock?
What's your Phone Number?
(We may call/text to assist you with any questions and your habit)
Enter your email address to receive your report
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