Private Coaching Intake Form with Eric Farewell

Private Coaching Intake Form with Eric Farewell

Welcome! Please complete this 75-question intake form as we go into your 12-month coaching journey with Eric. We recommend that you dedicate at least an hour to answering all of these questions and yes, in one sitting to keep you in momentum (and remembering your previous answers).
Full Name

1. First Name2. Last Name
3. Email Address
example@example.com
4. Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
5. What is your physical home address?

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
6. Where are you from originally?
7. What is your relationship with your birth family like?
Example: I am really close with my mom and I do not have a relationship with my father.
8. Do you still connect with your family? If so, how often?
9. What's one early childhood memory that shaped how you see the world?
10. Give me a background on your career?
11. What key skillsets and attributes got you to where you are today?
12. What does your annual income or business revenue look like currently?
13. Where do you want your income and revenue to be?
Pretend you have a magic wand and affirm what you desire. Current income/revenue: x Ex: In 3 years, I want my company's revenue to be at $10M per year.
14. What does your typical day look like? Share the rhythms.
15. Where do you feel most energized during your day, and why?
16. Who was your all-time favorite teacher and why? What were their characteristics?
17. Have you ever had resistance to a co-worker or an authority figure in your life? If so, what was the mirror that they held up for you and what were the characteristics that you had struggled with?
18. What are you most grateful for in your life and why?
19. Who is the most meaningful person in your life? The one that when you think about them it instantly makes you feel good inside? And why? What is it about their character?
20. Do you have any role models that you currently look up to or people you admire and if so, why?
21. What inspires you? There are no wrong answers.
22. What environments make you feel most alive and creative?
23. What are your top 3 core values and why are they important to you?
24. What part of you felt true resonance inside of working with Eric? What are the characteristics in Eric that has you wanting to do 1-on-1 coaching with him?
25. What does your soul most need from this coaching container?
26. If you could create your dream outcome over the year working with Eric, what would that look and feel like?
27. What does your vision for your life look like? Why is it important for you to make that vision a reality?
28. Now, what does your vision for your business look like? Why is that important to you?
29. What are your short-term goals for the next 12 months?
30. What does it feel like when you envision yourself accomplishing those short-term goals?
31. What are your long-term goals for the next 10 years?
32. What does it feel like when you envision yourself accomplishing those long-term goals?
33. What would be a dream milestone that would make you stop and say, I can't believe this is real?
34. What obstacles do you see that might prevent you from achieving your goals and why?
35. What will you do differently tomorrow to meet those challenges?
36. How can I support you in overcoming those challenges?
37. Where do you feel most stuck in your routines?
38. What do you consider to be your greatest strengths and why do you believe they're your greatest gifts?
39. What are your greatest strengths in your business?
Ex: Sales, marketing, inspiring your team, etc.
40. What are your greatest weaknesses in your business?
Ex: I don't know how to _______.
41. Why is it important for you to close these gaps?
42. How can you work to make that weakness a strength?
43. What internal beliefs or narratives might be keeping those weaknesses in place?
44. What are the strong areas that you are aware of that are in your intimate relationships?
45. What are the weak areas that you are aware of that are in your intimate relationships?
46. Why is it important for you to improve your intimate relationship?
47. How can you work to make intimacy a strength?
48. What are the strong areas that you are aware of in your friendships?
49. What are the weak areas that you are aware of in your friendships?
50. Why is it important for you to improve in that area?
51. How can you work to make your friendships a strength?
52. What are the strong areas that you are aware of in your mental health?
53. What are the weak areas that you are aware of in your mental health?
54. Why is it important for you to fill that gap in your mental health?
55. How can you work to make that mental health weakness a strength?
56. What areas of your physical health are strongest?
57. What areas of your physical health are weakest?
58. Why is it important for you to fill that gap in your physical health?
59. How can you work to make that physical health weakness a strength?
60. What daily practices (if any) currently support your physical, mental, and emotional well-being?
61. If you were to design a ritual that grounds you in your power each day, what would it include?
62. What do you do for fun?
63. What makes you feel like a kid again?
64. What emotion or energy are you most comfortable expressing?
65. What emotion or energy are you most uncomfortable expressing?
66. What do you tend to avoid, procrastinate, or push off that you know matters?
67. What do you believe about your worth right now?
68. What belief are you ready to let go of?
69. If it was impossible to fail, what decision would you already have made?
70. What would your future self a year from now thank you for doing today?
71. What legacy would make you feel proud?
72. When it's all said and done, and you're on your final days on this Earth, what kind of impact on humanity would you be proud to have made?
73. What will success look and feel like to you at the end of our 12-month journey together?
74. What's one thing you'd like to be asked that you haven't been?
75. What question are you afraid to answer, but know could unlock everything if you did?
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