1) Rate your life on a scale of 1 to 7 in the following areas? (1 being ‘terrible' and 7 meaning life couldn't be any better!)
a)
1
2
3
4
5
6
7
Physical Health
b)
1
2
3
4
5
6
7
Mental/Emotional Peace
c)
1
2
3
4
5
6
7
Finances
d)
1
2
3
4
5
6
7
Vocation/Calling
e)
1
2
3
4
5
6
7
Romantic Relationship
f)
1
2
3
4
5
6
7
Family and Friend Relationships
g)
1
2
3
4
5
6
7
Stress Level (1-high stress, 7 no stress)
h)
1
2
3
4
5
6
7
Recreation/Vacation
i)
1
2
3
4
5
6
7
Self-Care (how well do you care for you?)
j)
1
2
3
4
5
6
7
Spiritual Happiness
2) Over the next six months, what are three changes you could make to your life or three goals you could achieve that would really make a difference to you?
3) Imagine you have successfully accomplished the above 3 changes or goals! Great job! Now describe how your achievement feels and what benefits resulted for each one.
4) What personal goals or values have you placed on the back burner because of other life priorities?
5) What are 2 things you are most proud of having accomplished at this point in your life?
6) What three things are you currently enjoying in life?
7) What are the three biggest challenges you are facing right now?
8) What's the single biggest change you would like to make in your life?
9) What are you most grateful for?
10) If money was no issue, how would you spend your time?
11) What's the first thing you would want to start working on if you were to hire a coach?
12) What are three things (people, junk or tasks), behaviors or habits that you could let go of, change or do away with completely?
13) What's keeping you from getting the things you want and deserve in life right now?
14) How do you typically sabotage or cause problems to yourself in life, work and relationships? (Write your own answer or select from the list below.)
15) People who know you best, would probably describe you as:
16) If you were to ask your friends and family what they suggest you work on with a coach, what might they say?
17) What are three personal outcomes that would make coaching worth it to you?
18) Goals are much easier to achieve when you have a strong support structure. What structures will you put in place to insure your goals are achieved? (Select only 3)
19) What are you hoping the coaching relationship can provide for you? (Write your own answer or select from the list below.)
20) What's your hesitation about getting started in the coaching relationship now?
21) If you ever decided to start working with a coach, when would be the best time to start?
22) Please provide your contact information:
23) Optional: If you have a favorite or meaningful photo of yourself that you can easily attach and are willing to part with, please attach it to this document. I would like to have a photo so that I can have a face to connect with emails and phone conversations.
24) How did you hear about More Authentic Life?
25) Any Comments/Feedback/Questions:
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