Coaching Discovery Call Questionnaire

Please complete this questionnaire as honestly as you can, prior to our coaching discovery call.  This not only gives you the opportunity to assess yourself and think about your goals, but it will also help to shape our conversation when we meet.

Thank you

with blessings


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Question 1 of 14

What is your...


Day Phone number

Evening Phone number

Email address

Question 2 of 14

Briefly describe why you are interested in having life coaching.  What goals would you like me to help you achieve?

Question 3 of 14

If you were to rate the following areas of your life on a scale of 1 to 10, with 1 being very poor, and 10 being excellent.  Which ones (if any), would you score less than a 5.

(Select all that apply)

Physical Health


Emotional Health


Relationships (Primary)




Spiritual Health


Job or Career


Financial Prosperity


Sense of Purpose


Assertive ability


Time Management

Question 4 of 14

What else would you like me to know about you?

Question 5 of 14

Are you in therapy or taking medication?  If yes, please explain

Life Coaching is about balance.

The skills or creating what you want in one area of life will transfer to other areas.  For each of the life areas below, write down what you would like to achieve as specifically as possible.  Be as extensive as you'd like.

Question 7 of 14

Professional Goals:

Question 8 of 14

Financial Goals

Question 9 of 14

Physical (Health) Goals:

Question 10 of 14

Relationship Goals:

Question 11 of 14

Emotional Goals:

Question 12 of 14

Spiritual Goals:

Question 13 of 14

And lastly...

In the past, what has helped you achieve goals you've set?

What are a few of your strengths?

What additional skills do you need to achieve your goals?

Thank you for completing this questionnaire

I look forward to speaking with you on the coaching discovery call shortly.

with blessings


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