Coaching Complimentary Session Intake Form

Client Pre-Call Prep Form

30 minute Complimentary Session
How did you hear about us? *
What services are you seeking with Vital Ability, LLC? *
I am requesting services as an: *
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Primary Phone Number *
Secondary Phone Number
E-mail *
Employment Information
What Is Your Employment/Career Status? *

Employed Self-Employed Unemployed (laid off, etc) On Disability, not working On Disability and working Retired/Semi-Retired
Occupation
Employer (if employed)
Personal Information
Date of Birth *

Month Day Year
Marital Status *
Children?
How Many Kids? Ages?
As your coach it is important for me to understand how you view the world in general and yourself in particular.

Every person has their own unique and personal way of interacting with their surroundings.

These questions will hopefully provide a means for me to understand you and your current position more closely and thus enable me to discuss the coaching you are looking for.

Please take some time to answer these questions as thoughtfully and clearly as possible. These questions are designed to be “mulled over” and to stimulate your thinking on what you may want to discuss during our 30 minute Consultation session together.

If you have any questions or concerns, write them down, bring them with you to your session and please let me know what they are and we can discuss them.
How does what you do professionally contribute to achieving your personal goals?
If you could change some aspects of your professional situation what would you choose to change?
What do you consider to be your greatest accomplishments so far?
What activities have meaning and heart for you, or fill you with joy or a sense of pride?
Do you know your preferred style of learning? If so, what is it?
How do you find you are best motivated? Internally? Externally? Both?
What do you believe to be your most important values? Do you believe you are living congruently with these values?
How do you respond when you are in a really challenging situation?
What three steps could you take immediately that would make the greatest difference in your current siutation(s)?
Goals
What are your top 5 goals, either short or long term, at the moment?
Challenges
What are your top 5 challenges at the moment?
Coaching
What are your major objectives or gains that you wish to achieve from coaching?
What can I say or do when you are “stuck” that will help you return to action?
How do you want me to be as your coach?
We want you to get maximum benefit from your coaching experience. This is determined by our beliefs & the rules we have about coaching & its ability to contribute to the quality of our life. What do you need to believe for coaching to have the biggest impact on your life?
What else would you like to say?
Let's get you set up for that 30 minute Consultation appointment. Pick a time that works for you. Let's get started.
Appointment
Thank you!

Caren Robinson

Vital Ability, LLC

www.vitalability.com
Should be Empty:

Client Pre-Call Prep Form

Employment Information

Personal Information

Goals

Challenges

Coaching