CHCP STRATEGY SESSION QUESTIONNAIRE

Certified High Performance Strategy Session

QUESTIONNAIRE
The goal of this session is to help you reach heightened levels of clarity, energy, courage, productivity, and influence on your march to a successful, healthy, and fully charged life.

Instructions: Please answer the questions below and on the following pages to the best of your ability. The questions help me get to know your goals and to understand how you are performing in the six pillars of high performance: psychology, physiology, productivity, persuasion, presence, and purpose.
Your Full Name
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Occupation
Date of Birth

MonthDayYear
Date
Questions
Please briefly describe how you heard about my coaching services and why you would like a Strategy Session with me.
Please rate yourself in the following areas of your life on a scale of 1 (lowest) to 10 (highest)
Clarity:
Do you feel you are clear about who you are, your purpose, and the direction you want to go in life?

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10

1 is Worst, 10 is Best
Energy:
Do you consistently have enough mental and physical energy needed to excel, accomplish your goals, and feel motivated and happy?

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10

1 is Worst, 10 is Best
Courage:
Do you take action and consistently express who you truly are and what you truly think, need, and desire with the world?

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10

1 is Worst, 10 is Best
Productivity:
Are you consistently focused and effective, and are you good at minimizing distractions and maintaining priorities?*

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10

1 is Worst, 10 is Best
Influence:
Do you feel you have the social influence with your family, friends, and team needed to accomplish your goals?

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10

1 is Worst, 10 is Best
1. What do you do for a living, and why did you choose that career?
2. What are your top 3 goals you are striving to achieve right now?
3. What major stressors or challenges are your struggling with right now?
4. When you feel like your most successful and happy self, what makes you feel that way?
5. What would your dream life look like if you could wave a wand and make it happen?
6. What else has prevented you from having the dream life?
7. What goal or dream have you ever given up on or failed at?
8. What 3 big changes would you like to make in your life in the next 12 months?
9. What are you most proud of and excited about in your life?
10. Why would you like to work with a high performance coach?
Should be Empty:

Certified High Performance Strategy Session

Questions

Please rate yourself in the following areas of your life on a scale of 1 (lowest) to 10 (highest)

Clarity:

Energy:

Courage:

Productivity:

Influence: