Get Help with Life, Love, & Career!
Welcome to our website. If you have landed on this page it is for a reason. It shows that you are searching for answers and ready to take the next step. You want to see positive changes in your life and want to make it happen. Let us show you how. If you are ready to make a change and would like help in your journey, please fill out this form.
Name
*
First Name
Last Name
Please specify your age range below
*
20-30 years
30-40 years
40-50 years
50-60 years
60 and up
Other
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
What country do you live in?
Canada
USA
UK
Other
What is your preferred method of communication?
Email
Phone
Text
Other
How did you find M. Williams Life & Career Coaching website?
*
Internet Search
Classified Advertisement
Referral from former client
Professional Directory
Other
Referral Source: Please provide the specific place, name of the person,company, or website that you've indicated above so we can thank them!
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What type of assistance are you seeking?
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Life Coaching
Relationship Coaching
Career Coaching
Professional Development
Other
What is your current work status?
Employed
Unemployed
Student
Retired
Self Employed
What is your educational background?
Highschool
Some College
College
University Degree
Other
What do you like about your life right now? List some of the positives.
What do you NOT like about your life right now? What would you change?
Have you ever taken a personality test?
Yes
No
If yes, what were the results?
What has prompted you to consider hiring a coach for help right now?
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Have you ever worked with a coach before?
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Yes
No
If you answered yes, please describe what you worked on and for how long?
If you have worked with a coach before was it successful? Why or why not?
What do you think the role of a coach is?
*
Are you aware that coaching is not the same as counseling?
Yes
No
If you are aware, please explain why you chose coaching over counseling? (if not applicable, please type N/A)
Have you reviewed the Frequently Asked Questions on our website? (If no, a link will be provided at the end of this form submission)
Yes
No
What is it that you hope to accomplish by working with a coach?
What do you think is a realistic timeline to achieve your goals?
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30 days
2-3 months
6 months
one year or more
What is your approximate monthly ($) budget for coaching?
Do you have any financial concerns or constraints?
Yes
No
If you answered, yes, please explain. (If not applicable, type N/A)
Do you have any other commitments in your life that could possibly distract you from completing your goals or engaging in coaching sessions? If so what are they?
What do you think is holding you back from achieving your goals? Why is that?
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Which of these words best describe you?
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a pessimist
an optimist
goals driven
a procrastinator
a dreamer
hopeful
fearful
happy
stressed
balanced
go getter
How much time are you willing to devote to working on your goals in order to see positive changes in your life or career?
weekly
bi-weekly
monthly
once a month
customized plan
What is your preferred coaching method?
Phone
Virtual Online
In Person
Combination of all of the above
What time of day works best for you for regular coaching sessions?
Mornings
Afternoons
Evenings
What day of the week is preferrable for you?
Mondays
Tuesdays
Wednesdays
Fridays
Weekends
How ready are you to commit to signing up for regular coaching to meet your goals?
Extremely - I am ready
Maybe - I don't know if I am ready
Yes, but I need help to stick with a plan
Not yet - I need more time
Other
Describe the best way(s) that we can help you to accomplish your goals?
What are your expectations for coaching? What would you like to happen? How would you like us to spend our time?
What needs to happen in order for you to "pull the trigger" and truly commit to starting a coaching program in the next while?
Feel free to upload any documents that you feel may be relevant to our call (ie. resumes, letters, or other pertinent materials) that you would like to discuss.
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