Coaching Questionnaire:

Any and all information you submit is held in strictest confidence. I will never sell or otherwise give out any information you provide.

First and Last Name (required):

Location (state/country):

E-mail Address (required):

Website Address (if applicable):

Home Phone# (with area code):

Best Time to Reach You:

Referred By (if applicable):

What is the greatest opportunity in your life right now?

What is the greatest challenge in your life right now?

Describe the situation you want to discuss during our session:

When this session is completed, what will you want to have accomplished?

Have you ever been in a coaching relationship either as the coach or being coached? If so, what was that like for you?

What short-term benefits would you be interested in receiving from a coaching relationship?

What long-term benefits would you be interested in receiving from a coaching relationship?

Is there anything else that I should know that would facilitate accomplishing your intended outcome or anything else that you would like to communicate?

Thank you for completing this questionnaire. This is really where the coaching begins. By spending time here you set the stage to receive maximum value from your coaching experience.