Ministry Leadership

Ministry Leadership

Coaching Intake Form
Name*

First NameLast Name
I'm interested in:*

Free Coaching1 on 1 Leadership CoachingTeam CoachingFractional Executive Pastor
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Of Birth*

MonthDayYear
Date
Church or Organization Name*
If you serve at a church, what is the average weekly attendance?
Years at this organization?*
Position / Title*
Years in this position?*
Briefly describe your education background. *
What is your personal life mission / vision statement?*
Have you received coaching before? If so, what was your experience like?*
Are you willing to commit time and effort to implement the strategies we discuss?*

YesNo
What is your biggest leadership challenge right now?*
What’s the #1 thing you’d like to improve in your ministry?*
What’s causing the most stress in your life?*
What areas do you feel you need to improve in the most?*
Who are the most significant people in your life and what do they provide for you?*
What are you doing on a regular basis that keeps you physically, mentally, emotionally and spiritually well?*
This is a good place to mention your hobbies, your exercise and devotional, routines, and anything else that keeps you going.

List up to 5 “time wasters,” excuses or ways you use to avoid hard things.*
What values and principles guide your decisions?*
Have you taken any personality assessments? i.e. Enneagram, Myers-Briggs, Strength finder, DISC, 360… Share those results. *
What encourages or motivates you?*
How will you know that you are receiving value from this coaching relationship?*
What else would you like me to know about you?*
Is there you'd like to know about me?*
Should be Empty: