90 Day Life Coaching Questionnaire
Inspired Life - Create the Life You Desire and Deserve!
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Occupation
Age Group
Please Select
Under 25
25-34
35-44
45-54
55+
What are your goals for the next 90 days?
Which of the following are most important areas of focus?
Please Select
Financial Planning and Wealth Building
Fitness and Wellness
Healthier Relationships
Self-Improvement
What does your ideal life look like?
Do you currently have a budget that you follow consistently?
What is your biggest financial challenge at the moment?
How do you rate your current physical fitness?
Please Select
Excellent
Good
Fair
Poor
Do you have a regular exercise or wellness routine?
What wellness of fitness goals would you like to achieve during the 90 Day program?
How do you currently handle stress and challenges?
Please Select
Very well
Well, but could do better
Not well, I struggle often
What limiting beliefs or fears do you feel are holding you back?
How often do you practice self-care or mindfulness activities?
Please Select
Daily
Weekly
Rarely
Never
How much time can you dedicate each week to coaching and personal growth?
On a scale of 1-10, how committed are you to achieving your goals during this 90 day coaching program
What kind of support or accountability do you find most effective? (check all that apply)
Please Select
Regular check-ins
Accountability partner
Written Goals and tracking
Positive reinforcement
Other, Please specify
Is there anything else you'd like us to know to better support you on this journey?
Appointment
Submit
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