Please fill out this questionnaire so that we can help match you with the coach who best fits your needs and goals.  All client information is strictly confidential and never shared with anyone else.

First Name 
Last Name
Address
Home Phone
Work Phone
E-mail address

Life Purpose
In 25 words or less, what do you consider your life purpose to be?
 

How certain of your life purpose are you?

I know exactly what my life purpose is and I知 living consistent with it all of the time.
I know exactly what my life purpose is and I知 living consistent with it most of the time.
I know exactly what my life purpose is and I知 sometimes living consistent with it.
I know exactly what my life purpose is, but I知 rarely living consistent with it.
I know exactly what my life purpose is, but I知 not living consistent with it.
I am somewhat certain what my life purpose is.
I have only a rough idea of what my life purpose is.
I don稚 know what my life purpose is.
I don稚 fit on this scale at all.
 
You and Your Coach
Have you ever been involved in a coaching relationship (either as a coach or client)? 
 
Do you want to consult with your coach in person or over the telephone?
 
How often would you like to be in contact with your coach?
 
What are the three most important things you would like your coach to help you work on?
 
What would you like to address or accomplish in your first coaching session?
Do you have any questions or anything else you would like to communicate to us?
 

How did you hear about us?

 

Thank you for completing our initial Coaching Questionnaire.  A customer service representative will be in touch with you shortly so that you can begin your coaching.


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