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Coaching Application
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19
Questions
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1
If there was ONE BIG CHANGE that you wanted to make in your life what would it be? What is the biggest challenge, fear, frustration, or problem that's getting in your way of making that change? Please be as specific as possible.
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This is a big question, I get it. Take your time.
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2
Name
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First Name
Last Name
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3
Email
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example@example.com
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4
Whatsapp Number
Area Code
Phone Number
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5
How old are you?
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6
What's your Instagram?
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@YourIG
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7
Give yourself a score in these areas
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1=Not at all; 10=100%
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Clarity - I feel that I am clear about who I am, my values, purpose, and the direction I want to go in life.
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Mindset - I feel that I am in a good place mentally (my self talk, self-perception)
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Love - I am happy and fulfilled with myself and my relationships or partners.
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Communication - I am able to express myself authentically and genuinely in any situation
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Confidence - I am reliant and step up for myself and others in uncomfortable situations.
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Body Image - I am happy and secure in my own skin.
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Energy - I have enough mental and physical energy needed to accomplish everything I set out to accomplish on a consistent basis.
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Efficiency - I am efficient, consistently focused and I am good at minimizing distractions and maintaining priorities.
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Clarity - I feel that I am clear about who I am, my values, purpose, and the direction I want to go in life.
Mindset - I feel that I am in a good place mentally (my self talk, self-perception)
Love - I am happy and fulfilled with myself and my relationships or partners.
Communication - I am able to express myself authentically and genuinely in any situation
Confidence - I am reliant and step up for myself and others in uncomfortable situations.
Body Image - I am happy and secure in my own skin.
Energy - I have enough mental and physical energy needed to accomplish everything I set out to accomplish on a consistent basis.
Efficiency - I am efficient, consistently focused and I am good at minimizing distractions and maintaining priorities.
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8
What are your top 3 goals that you are after right now?
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9
What major stressors or challenges are getting in your way right now?
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10
When do you feel like your most successful and content-self, what makes you feel that way?
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11
What is your current relationship status?
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12
If you had all the time and money in the world, where would you be, what would you be doing and who would you be with?
*
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This one is fun, dream a little. GO BIG!
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13
What has prevented you from having that ideal life?
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14
What limiting beliefs do you have around yourself and what you are able to achieve?
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15
What failures have you experienced in the past that you failed to learn from?
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16
Evaluate yourself in these areas.
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1=Not at all; 10=100%
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My Relationship - I'm in a fulfilling relationship or ready to be in one.
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My Overall Health - I sleep well, manage stress effectively, eat well, exercise and take care of my physical environment.
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My Self Talk - I am optimistic, identity negative self talk and change my perspective quickly.
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My Hobbies - I have activities outside of my work that challenge me.
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Family and Friends - I keep developing deep and loving relationships with people close to me.
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Finances - I am ahead of where I expected to be at this point of my life.
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Mission & Purpose - I am clear about my role in this world.
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Spirituality - I have a spiritual/meditative practice and keep deepening it on a regular basis.
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My Relationship - I'm in a fulfilling relationship or ready to be in one.
My Overall Health - I sleep well, manage stress effectively, eat well, exercise and take care of my physical environment.
My Self Talk - I am optimistic, identity negative self talk and change my perspective quickly.
My Hobbies - I have activities outside of my work that challenge me.
Family and Friends - I keep developing deep and loving relationships with people close to me.
Finances - I am ahead of where I expected to be at this point of my life.
Mission & Purpose - I am clear about my role in this world.
Spirituality - I have a spiritual/meditative practice and keep deepening it on a regular basis.
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17
What would happen if you stayed exactly where you're currently at?
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18
How much would you be willing to invest in yourself to optimize every area of your life and create the life you desire?
(in AUD)
$1,000-$2,500
$2,500-$5,000
$5,000-$7,500
$10,000-$13,000
I don't have the money right now.
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19
Is there anyone else involved in you making this decision? If so who?
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