Lifeline Coaching Pre-Questionnaire
"This is Required Prior to any Package Offered"
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
1. On a scale 1- 10, do you know what you want
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Not Sure
1
2
3
4
5
6
7
8
9
Very Sure
10
1 is Not Sure, 10 is Very Sure
2. On a scale 1 -10, how clear are you on what your goals are?
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Not Clear
1
2
3
4
5
6
7
8
9
Very Clear
10
1 is Not Clear, 10 is Very Clear
3. On a scale 1- 10, how motivated are you to achieve your goals?
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Not At All
1
2
3
4
5
6
7
8
9
Very Motivated
10
1 is Not At All, 10 is Very Motivated
4. On a scale 1- 10, how urgent is it that you do something about this now?
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Not Urgent At All
1
2
3
4
5
6
7
8
9
Very Urgent
10
1 is Not Urgent At All, 10 is Very Urgent
5. On a scale 1- 10, how committed are you to work with a Life Coach?
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Not Really
1
2
3
4
5
6
7
8
9
Very Committed
10
1 is Not Really, 10 is Very Committed
6. On a scale of 1- 10, do you believe I can help you?
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Not Sure
1
2
3
4
5
6
7
8
9
Yes, Definitely
10
1 is Not Sure, 10 is Yes, Definitely
7. Have you looked into your budget to see if you can work with a Life Coach for 90 days?
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Yes
No
8. Are you at least 18 years old or older?
*
Yes
No
Tell me in 2 - 4 sentences, what you expect to gain from coaching sessions.
*
Submit
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