New Client Questionnaire

NEW CLIENT QUESTIONNAIRE
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Please provide responses to each statement: 1 (strongly agree) to 5 (strongly disagree)
I feel that I am capable of having the life I really want.
I am open to experimenting with new ways of doing things in my life.
I am willing to be disciplined and follow through with my commitments.
I am a positive person.
I hold myself fully accountable for the results I create in my life.
I have a clear vision for my life and what I am committed to accomplishing.
I do well when working with others.
I live with a high level of integrity.
I am supported by the people in my life and they are committed to my success.
I am committed to my own personal growth and am willing to invest the necessary time and energy.
When I have a setback in life, I am able to bounce back quickly.
I am able to receive support and contribution from others.
What influenced your decision to start working with a life coach?
Have you ever worked with a life coach before? If so, please describe your experience.
What part of your life is working well?
What part of your life could be working better?
What do you want to focus on first in your work with me?
What are some obstacles that keep you from achieving your goals?
What are your life values? What is most important to you?
What is success in your opinion?
If you knew you wouldn't fail, what would you love to do?
What is your biggest fear?
What is your biggest reoccurring complaint about yourself?
What are you biggest personal strengths?
What is your biggest personal weakness?
Should be Empty:

NEW CLIENT QUESTIONNAIRE

Please provide responses to each statement: 1 (strongly agree) to 5 (strongly disagree)