Leadership Performance Coaching with Carole

Leadership Performance Coaching with Carole

Please take time to complete the following form. I will reach out to schedule a discovery session.
Name*

First NameLast Name
Best Email for communication*
example@example.com
What is your cell?*

Area CodePhone Number
Can I text you?*

YesNo
What do you want most right now? Why?*
What does success look like to you?*
What is working well in your life right now?*
What do you see as an obstacle to your success?*
How do you handle pressure?*
What are you tolerating right now? *
Which of the following do you feel are keeping your from reaching your goals?*

Lack of commitmentPoor time managementProcrastinationLack of goal settingNegative self-talkFearStressRejectionDistractionsLow confidencePast traumaOutside influencesLack of patienceLack-luster relationship with GodFinancial challengesLack of balanceLack of support

What would it be worth to you to address these issues or what is the cost of not addressing them?

	1	2	3	4	5

1 is Worth little, 5 is Worth so much

Are you currently under a medical professional's care for depression or anxiety?

yesno
Are you currently receiving counseling or therapy from a medical professional?

yesno
What are your expectations from coaching?*
AGREEMENT: By submitting this document, I understand all information I entered is considered strictly confidential. The data gathered from this form will only be used as a basis for the type of coaching the client will receive. I understand to be successful, it is vital to follow the plan agreed by both the life coach and client.
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