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Operated via The Integrated Unthrottled Life, LLC
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Client Intake Information

I, as the undersigned, am giving real and true information to allow for the findings of my synthesis map by The Integrated Unthrottled Life LLC. I certify the information provided is in fact my own information to share and I give my permission to use it in coordination with the client agreement scope.

Part A: 1. Where do you get your energy?

Part A: 2. How do you process information?

Part A: 3. How do you make decisions?

Part A: 4. How do you approach the outside world?

Part B: Choose the letter that best fits you on most days. Pick the statement that resonates with your deepest "why."

Part C: Rate your level of agreement

(1 = Strongly Disagree, 3 = Neutral, 5 = Strongly Agree)

A. I find it relatively easy to get close to others and am comfortable depending on them.

B. I often worry that my partner/friends don't really love me or won't want to stay with me.

C. I am nervous when anyone gets too close to me, and I often feel like people want more intimacy than I am comfortable providing.

D. I want to be close to others, but I find it hard to trust them or depend on them because I'm afraid of being hurt.

Part D: Place In Order

Number these statements in order from most (1) like you to least (4) like you, in a disagreement.

I state my needs clearly and respectfully, while listening to the other person's perspective.

I stay quiet or give in to avoid conflict, often at the expense of my own needs.

I prioritize winning the argument and may use "you" statements to blame or dominate.

I avoid direct confrontation but express my frustration through sarcasm or "the silent treatment."

Part E: Rank 1 to 5

Rate from 1 to 5 (1 being the highest/most important) of what makes you feel most cherished.

Compliments, "I love you," or verbal encouragement.

Someone doing the dishes, running an errand, or helping with a task.

Thoughtful tokens that show someone was thinking of you.

Undivided attention and shared activities without distractions.

Hugs, holding hands, or physical closeness.

Part F: 1. The Primary Requirement

Choose the statement that feels most essential for a sincere apology.

Part F: 2. The Source of Sincerity

Part F: 3. The Path to Restoration

Part F: 4. The Proof of Change

Part F: 5. The Emotional Connection

Analyzing your responses...

Please wait while we generate your synthesis map.

Submission Complete!

Thank you for completing the Ultimate Questionnaire. Your authentic engagement helps ensure accurate alignment. Your results have been confidentially transmitted.

We look forward to working with you and assisting in developing your synthesis map for you greatest good in life and to assist in not only finding what your internal glitches are, but to be able to give tangible advice and information to point you down a path to finally live at the speed of your intelligence and arrive at your best life.

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