Name
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First Name
Last Name
Email Address
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Phone
What brings you to coaching?
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Or, put another way, if your closest friend or family member were to ask you, "What’s really going on with you?” How might you answer?
What are your primary goals/objectives?
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Or what are you looking for that you feel you don’t have at this time? Where would you like to see yourself after working together? What do you want?
What have you done so far to obtain this goal or desire?
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List everything you’ve tried, what your strategy has been so far, how you have changed, new skills you have acquired. It’s okay if you are at the beginning and haven’t tried anything yet.
Have you worked with a coach before? Please share your experience:
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What do you want to be sure to get from the coaching relationship?
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How do you want me to be as your coach?
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What do you need to change in your life to help you move forward?
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What do you believe in strongly? What are your values?
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Are you under medical/ therapeutic treatment? If yes, explain:
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Are you taking any medication? If yes, please list:
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Do you have a support system, network, or community?
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Specifically, who is supporting your goals? Please explain:
What does your self-care consist of?
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How good a friend are you to yourself?
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How would you rate your physical health and diet?
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What are your deeper callings that you want to be answered or expressed?
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What would you say is really working for you right now?
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What areas of your life are just how you want them to be?
Share with me your strengths:
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Is there anything you think I should know that you haven’t already shared?
