Establishing an effective coaching relationship from the start will enhance your experience moving forward. I value the opportunity to get to know you. These questions help me gather the information I need to help you reach your goals. This information is confidential.
Please identify up to three areas that you want to be your MAIN focus during this coaching relationship. For each focus area, provide a simple heading and short description of the results you desire to achieve.
Name: First Name Last Name Address: Street Address City State Zip Primary Phone: Phone Number Other Phone: Phone Number Email: Email
Spiritual Health 1 2 3 4 5Physical Health 1 2 3 4 5Financial Health 1 2 3 4 5Career Health 1 2 3 4 5
Overall Stress Level 1 2 3 4 5 Helpful Support Systems 1 2 3 4 5Emotional Health 1 2 3 4 5Relationship(s) Health 1 2 3 4 5Spiritual Health 1 2 3 4 5Physical Health 1 2 3 4 5Financial Health 1 2 3 4 5Career Health 1 2 3 4 5
Overall Stress Level 1 2 3 4 5 Helpful Support Systems 1 2 3 4 5Emotional Health 1 2 3 4 5Relationship(s) Health 1 2 3 4 5
Birthdate: Date Occupation: Type a label Marital Status: Please Select Single Committed Relationship Married Divorced Widowed Years Married: Years Spouse: Type a label