Life Coach Atlanta Client Questionnaire
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Name
First
Last
Email
Phone
Age
*
Relationship Status
*
Single
Married
Partnered
Divorced
Occupation
*
Gender Identification
Female
Male
Trans Female (MTF)
Trans Male (FTM)
How did you hear about I Speak Life Coaching?
*
Rate Yourself On A Scale Of 1-10
Rate yourself on a scale of 1-10 in each of the following areas. 1 being, that you have not made any progress in this area and 10 that you are where you think you should be by this stage in your life. For example, in the area of finances, if you are 50% of where you think you should be at this stage in your life, then give yourself a score of 5. This exercise only takes a few minutes, but will help you pick goals in the areas of your life that it would most beneficial for us to focus on. After all, it won’t do you any good to be coach on what you are already doing well. The coaching process will be most useful for the areas that have the most room to grow.
Health - Physical
*
1
2
3
4
5
6
7
8
9
10
Finances
*
1
2
3
4
5
6
7
8
9
10
Career
*
1
2
3
4
5
6
7
8
9
10
Relationships
*
1
2
3
4
5
6
7
8
9
10
Time Management:
*
1
2
3
4
5
6
7
8
9
10
Emotions
*
1
2
3
4
5
6
7
8
9
10
What type of coach are you looking for?
*
Executive/Professional
Relationship
Personal
What’s going great in your life?
*
List 3 outcomes/goals you want to see happen in your life.
*
What are you hoping to gain by participating in a life coaching session?
*
What are your struggles/limiting beliefs e.g. what do you often say "I can't" about?
*
Why is now the best time to take action on these goals?
*
Why are you a good candidate for our coaching and how do you think you will be able to benefit from a coaching experience?
