MIRROR & PATH
Only 3 fields are required: name, email, birth date. Everything else can be skipped — fill in what you like, the report just fits closer.
Write down anything that is worrying you, keeping you unsure, or hard to put down — a relationship, a job, money, one specific decision, or just something you cannot name. The more specific, the better.
e.g. "He has not replied for two days and I checked my phone forty times while telling myself it does not matter."