New Client Form

nice to meet you.

Congratulations on taking the next step towards your new coaching journey! Please set aside up to 20 minutes to complete this questionnaire. This tool is meant to provide an opportunity to get clarity about where you are, what you want, some limitations you are facing and how you can move towards the goals and life your desire.

To get the most out of this inquiry tool, find a quiet place, uninterrupted, so you can enjoy this time with yourself. This is your time to focus 100% on you. Free yourself from judgement and capture what comes to mind and speaks through the heart.

Take time to think about the questions, complete the ones that speak most to you, and you can even skip the ones that don’t.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Questions

If you were to tell me of a secret passion, one that is almost too exciting to do or do more of, what would it be?

What's missing in your life, the presence of which would have your life be more fulfilled?

Think of a peak time in your life, a time of extreme pleasure or adventure, learning or satisfaction, peace or well-being. It may be a moment in time, or may have happened over a long period. Describe this time, with as many pertinent details as possible. What was it about this moment or experience that made it so powerful?

What 3 changes do you most want to make in your life?

Why do you want to make these changes in your life now?

When have you attempted to make these changes before now? What happened?

What do you most want to achieve? How ready are you to achieve it? On a scale of 1 to 10; 1 being not that much and 10 being absolutely.

What are you tolerating in your life at present? (Examples: clutter, poor lighting, dented car, job dissatisfaction, dead plants, broken equipment, etc.)

What is your personal and/or professional vision?

On a scale of 1-10 (10 high), what is the quality of your life today.