Prospective Client Questionnaire

Prospective Client Questionnaire

Kayanın Spiritual Life Coaching
Hello and welcome! If you are interested in beginning a spiritual life coaching relationship with me, it is very helpful to fill out this questionnaire so that I have a sense of your personality, goals, and right fit for my style of spiritual life coaching. If you don't feel like sharing certain information at this point, you can of course declined to answer most questions. Your answers will be kept confidential. Thank you in advance for your time and enthusiasm ~
General Information
Name*

First NameLast Name
Email Address*
example@example.com
Age*
Must be 18+ to work with me
Date and Time of Birth (if known)

MonthDayYear
This is helpful information for human design and astrology work
AM/PM Option
Location of Birth (City/State/Country)
This is helpful information for human design and astrology work
Gender Identity

FemaleMaleNon-BinaryTrans FemaleTrans MaleGenderqueer/fluidIntersexOther
Sexual Orientation

BisexualStraight/HeterosexualGayLesbianPansexualQueerQuestioningAsexualDemisexualOther
Race or Ethnicity
Immigration Identity
If applicable
Languages Spoken
Religious/Spiritual Affiliation
If applicable
Ability/Disability Markers
If applicable
Family of Origin

BiologicalAdoptedFosterOther
Other Identifications to Note
If applicable
How did you find me?

Friend or relativeKayanin websiteProfessional referralOther
The Coaching Relationship
Have you experienced any kind of life coaching in the past?

NoYes
If yes, what was this experience like for you? What did you like or dislike about it? Was it effective for you?
What brings you to life coaching now?*
What are some possible goals or interests for you in your spiritual life coaching journey with me? Select as many as you like.

Personality/self-explorationRelationship skillsSpiritual alignment & purposeWork & vocational developmentHealth & fitnessSleep & dream workExploring sexualityInner child workEliminating limiting beliefsFinding fulfilling self-narrativesCultivating interests & passionsNurturing talents & skillsAccessing higher wisdomSocial justice issuesCultural identity issuesOther
What are your most defining beliefs? These may be spiritual or non-spiritual in nature. How do they help or hinder you?
What are your talents (innate qualities)? What are your skills (learned qualities)?
What do you consider to be your strengths?
What do you consider to be your weakness or growing edges?
What are your interests or passions? Dreams?
What length of time best reflects your ideal life coaching relationship?*

Limited (3-6 months)Short-term (1-2 years)Long-term (2-5 years)Lifetime/indefinite
Are you committed to giving the time, attention, money, and dedication to your spiritual life coaching journey?*

Yes!Mostly yes, but I have concernsUnsure
What are the factors motivating you to begin life coaching with me? What are the factors that may be limiting you from committing fully to the process?*
I am interested in which qualities in a life coach would be most helpful to you. You can select as many as you like. "I'm looking for someone who can..."

Help me understand myselfEmpathize with my strugglesHelp me change my limiting beliefsEncourage me when I'm feeling unmotivatedHold me accountable to my goalsHelp me be more loving and accepting toward myself and othersGive me structure and concrete steps forwardUnderstand my values and worldviewOther
It is absolutely critical for my coaching clients to understand that coaching is not therapy. Please answer the following questions and check the boxes below to acknowledge your understanding about the role of spiritual life coaching.
Do you have current mental health concerns or a mental health diagnosis?

YesNoUnsure
Are you currently receiving quality mental health care?(Strongly recommended.)

YesNoNo, but seeking
Key Relationships
What is your current relationship status/lifestyle?

SingleDatingLiving with PartnerMarriedDivorcedSeparatedWidowedNon-MonogamousPolyamorousOther
Who are the three most important people in your life? How do you feel about the key relationships in your life?
Are there aspects of your relationships that you wish you could change?
Overall, how satisfied are you with the relationships in your life? These can be romantic or platonic in nature.

Very satisfiedSatisfiedNeither satisfied nor dissatisfiedDissatisfiedVery dissatisfied
Describe your current living situation (alone, with others, with family, etc.).
Work and Vocation
What is your employment status?

Employed, full-timeEmployed, part-timeStudentUnemployedOther
How satisfied are you with your current career or vocational track?

Very satisfiedSatisfiedNeither satisfied nor dissatisfiedDissatisfiedVery dissatisfied
How do feel about work? What do you see yourself doing within your current or desired career track?
If situational factors like time, distance, money, education, or access were not barriers for you, what would you want to spend your life doing?
Additional Information
Is there any other information you would like to share with me?
Should be Empty:

Prospective Client Questionnaire

General Information

The Coaching Relationship

Key Relationships

Work and Vocation

Additional Information