New Client Questionnaire

The following questions are to help me get a clear understanding of your current state. Please answer them as completely and as truthfully as possible. All of your answers are confidential.

Please respond to each statement:
1 (strongly agree) to 5 (strongly disagree)

I feel that I am capable of having the life I really want. *

I am open to experimenting with new ways of doing things in my life. *

I am willing to be disciplined and follow through with my commitments. *

I am a positive person. *

I hold myself fully accountable for the results I create in my life. *

I have a clear vision for my life and what I am committed to accomplishing. *

I do well when working with others. *

I live with a high level of integrity. *

I am supported by the people in my life and they are committed to my success. *

I am committed to my own personal growth and am willing to invest the necessary time and energy. *

When I have a setback in life, I am able to bounce back quickly. *

I am able to receive support and contribution from others. *

What influenced your decision to start working with a life coach? *

Have you ever worked with a life coach before? If so, please describe your experience. *

What part of your life is working well? *

What part of your life could be working better? *

What do you want to focus on first in your work with me? *

What are some obstacles that keep you from achieving your goals? *

What are your life values? What is most important to you? *

What is success in your opinion? *

If you knew you wouldn't fail, what would you love to do? *

What is your biggest fear? *

What is your biggest reoccurring complaint about yourself? *

What are you biggest personal strengths? *

What is your biggest personal weakness? *

What part of your life could be working better? (copy) *

New Client Questionnaire

Please respond to each statement: 1 (strongly agree) to 5 (strongly disagree)

Please respond to each statement:
1 (strongly agree) to 5 (strongly disagree)