check

Free Coaching Session - Preliminary Questions

GOAL: To Help you reach heightened levels of clarity, energy, courage, productivity, and influence on your march to a successful, healthy, and fully charged life.

Click the button below to start.

Start

Instructions

Please answer the questions below and on the following pages to the best of your ability. We will both receive a copy of your responses at the end.

Question 2 of 28

Please Provide Contact Information

Full name
Phone number
Email address
Street Address
City, State/Province
Zip/postal code
Country

Question 3 of 28

More about you

Date of Birth
Gender
Occupation
Marital Status

Question 4 of 28

Please briefly describe how you heard about my coaching services and why you would like a Strategy Session with me.

Self-Assessment

Please rate yourself in the following areas of your life on a scale of 1 (lowest) to 10 (highest)

Question 6 of 28

Clarity

Enter a number below of 1 (lowest) to 10 (highest),

Do you feel that you are clear about who you are, your purpose, and the direction you want to go in life?

Question 7 of 28

Energy

Enter a number below of 1 (lowest) to 10 (highest),

Do you consistently have enough mental and physical energy needed to excel, accomplish your goals, and feel motivated and happy?

Question 8 of 28

Courage

Enter a number below of 1 (lowest) to 10 (highest),

Do you take action to consistently express who you truly are and what you truly think, need, and desire with the world?

Question 9 of 28

Productivity

Enter a number below of 1 (lowest) to 10 (highest),

Are you consistently focused and effective, and are you good at minimizing distractions and maintaining priorities?

Question 10 of 28

Influence

Enter a number below of 1 (lowest) to 10 (highest),

Do you feel you have the social influence with your family, friends, and team needed to accomplish your goals?

Question 11 of 28

1. What do you do for a living, and why did you choose that career?

Question 12 of 28

2. What are your top 3 goals you are striving to achieve right now?

Question 13 of 28

3. What major stressors or challenges are you struggling with right now?

Question 14 of 28

4. When you feel like your most successful and happy self, what makes you feel that way?

Question 15 of 28

5. What would your dream life look like if you could wave a wand and make it happen?

Question 16 of 28

6. What else has prevented you from having that dream life?

Question 17 of 28

7. What goal or dream have you ever given up on or failed at, and what do you believe caused you to stop or fail?

Question 18 of 28

8. What 3 big changes would you like to make in your life in the next 12 months?

Question 19 of 28

9, What are you most proud of and excited about in your life?

High Performance Questions

Personal Performance Questions

Question 21 of 28

1. What negative recurring thoughts, fears, or behaviors would you like to overcome in order to feel more psychologically free, confident, and successful?

Question 22 of 28

2, What eating, exercise, or general health habits would you like to begin or break in order to feel stronger and more healthy physiologically?

Question 23 of 28

3. What distracts you the most from being more productive, and what major projects or missions are you struggling to complete faster, or more efficiently?

Question 24 of 28

4. If you were more persuasive or influential, what dream or desire would you ask others to support you in achieving?

Question 25 of 28

5. When do you struggle to be fully present in your day or in any of your relationships?

Question 26 of 28

6. How purposeful do you feel in living each day, and how would you describe your purpose?

Question 27 of 28

7. Why would you like to work with a high performance coach?

Question 28 of 28

8. Why do you feel you could be a great student or coaching client if we worked together?

Confirm and Submit