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Initial Questionnaire for Transformational Coaching

Thank you for your interest in working with me. Tell me more about yourself, what brought you here and how you feel I can help?
First and Last Name *
Phone Number *
Email Address *
Where do you live?
Website if you have one
What are you struggling the most with right now that you are eager to work on and change? *
What kind of Breakthrough are you looking for? *
Have you worked with a coach before? If so, what was the outcome? *
If you have worked with another coach before tell me about your best coaching experience: *
What about your worst coaching experience and what did you learn from that? *
Tell me more about the perceived problems that you'd like to address working together? *
Do you see how you might have co-created the problems you're currently experiencing and in how many different ways have you already attempted to solve them? *
What is getting in the way of you living your best life? What actions do you know you should be taking but aren't? *
Are there any negative emotions that you feeling on the regular? *
If so, on a scale of 1-10, how intense are these negative emotions *
Not intense at all
Taking over my life
Are you aware of any limiting beliefs present in relation to your problem? Can you identify them for me? Do you know what a limiting belief is? *
How will you know that the problems have disappeared at the end of our time together? *
How would you show up in life if your "perceived" problems were to completely disappear? *
Are you looking to work together for *
Are you in a place where you are willing to invest the time, the work and money in yourself that is needed to make the shifts necessary in your life? My rates are $3000 + tax for 10 weeks. *
What do you want to walk away with having worked together? *
Why do you think I’m the best person to help you? How did you hear about me? *
Anything else you'd like to add?
I'm only willing to work with people who are committed to massive action and change. Is that you? Transformation is rarely easy, but it's worth it! *
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