Planning Your Coaching Call

Coaching Questionnaire
Congratulations on your commitment and desire to step up to the next level in your life and live purposefully on a daily basis.

In order for me to get to know you a bit more and to have your goals and challenges identified, I have prepared this form for you to capture this vital information.

Please take your time in filling out this form and put as much effort into being as detailed as possible so we can make the best out of your coaching sessions. I know this is a long-form, but I rather not use a coaching session on a discovery call and allow you to get your mind and inner desires onto paper/screen.

I would like to have this form filled out and submitted to me prior to our first call.

Freddy Behin, M.D.
Achievement Expert

Office: 909 - 92 92 92 2
Coach@FreddyBehin.com
Clients Name*
Clients First and Last Name
E-mail*
Phone Number*

Area CodePhone Number
Time Zone:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Your Goals

Lets get clarity around your goals
What are the 3 goals you want to achieve over the next three months?*
What are the three biggest changes you want to make in your life over the next three years? *
Your Personal History

Lets think about the significant parts of your life.
What would you say have been your three greatest accomplishments in your life to date?*
What is the hardest thing you have ever had to overcome?
Who are (or have been) your major role models? Would you be willing to add some? Why?
What major transitions have you had in the past two years?
(i.e. – entering or approaching a new decade of life, a new relationship, a new job, a new role, a new residence, changes in children’s ages/stages of life, separation, divorce, death of a loved one, birth of a child, marriage, etc.)
Your Life

Lets think about your current daily life situation
Describe the BEST DAY of your Life:
Describe the WORST DAY of your Life:
Who are the key people in your life and what do they provide for you?
Is your life one of your choosing? If not, which parts are being chosen for you?

On the scale of 1-10 what is your current amount of stress

	1	2	3	4	5	6	7	8	9	10

1 is No Stress, 10 is High Stress

What are your primary stressors?
List five (5) things that you are tolerating or putting up within your life at present.
(i.e. – information you cannot find, rude people, poor lighting, tight shoes, dented car, job dissatisfaction, dead plants, broken equipment, old appliances, etc.)
Coaching You

Lets create a win-win situation so I can serve you best.
What would you expect or like your Coach to do if you get behind on your goals?
(i.e. – incase you are not taking action and doing your assignments, how would you like me to remind you and reinforce the importance of them.)
How will you know when you are receiving value from the Coaching process?
What has to happen for you to know that your coaching sessions are successful and you are getting the benefits and your money’s worth.
What types of approaches discourage you or take away your motivation?
What would discourage you during our sessions?

How can your Coach best support you in the Coaching relationship? Using each number once, place the following in order of importance. 1=Least and 10=Most Important

	1	2	3	4	5	6	7	8	9	10
Brainstorming Strategies Together
Insight into Who You Are and Your Potential
Support, Encouragement, Validation
Exploring and Removing Blocks and Obstacles to Your Success
Accountability; Checking up on Goals
Working through Self-Improvement Programs Together
Suggesting or Designing Action Steps
Painting a Vision of What You Can Become or Accomplish
Strategic Planning
Directness: Asking Hard Questions; Challenging You to Move Forward

Your Potential & Possibility

Lets see the road ahead and where we are heading.
What is your PERSONAL vision?
What is your PROFESSIONAL vision?
What would you like to contribute to the world?
What is a DREAM or GOAL you have given up on?
What part of yourself, if any, have you given up on?
If you could only change one thing in your PAST, what would it be?
If you could only change one thing CURRENTLY, what would it be?

Rate the QUALITY of your LIFE today:

	1	2	3	4	5	6	7	8	9	10

1 is Low Quality, 10 is High Quality

Current Growth Level

This is obviously a subjective evaluation of how you feel about your knowledge on the following topics.

Controlling your Emotional state

	1	2	3	4	5	6	7	8	9	10

1 is Struggle, 10 is Mastered

Financial knowledge Level

	1	2	3	4	5	6	7	8	9	10

1 is Struggle, 10 is Mastered

Business knowledge Level

	1	2	3	4	5	6	7	8	9	10

1 is Struggle, 10 is Mastered

Relationship Mastery Level

	1	2	3	4	5	6	7	8	9	10

1 is Struggle, 10 is Mastered

Spiritual Level

	1	2	3	4	5	6	7	8	9	10

1 is Struggle, 10 is Mastered

Events and Products

What exposures have you had to Anthony Robbins materials.

Which Anthony Robbins seminars you have attended (check all that apply and indicate month and year attended)

	# times attended	Last Date Attended
Unleash The Power Within
Date With Destiny
Life Mastery
Wealth Mastery
Business Mastery
Leadership Academy
Other

Please list any other influencer and expert you have learned from and courses/seminars you have attended in the past.
Should be Empty:

Coaching Questionnaire

Your Goals

Your Personal History

Your Life

Coaching You

Your Potential & Possibility

Current Growth Level

Events and Products