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Pre-Coaching Survey
Please take a moment to reflect on the following and submit prior to our first session together.
Adres e-mail *
Name *
Think about how your life is going. Rank each area currently: *
Poor
Fair
Satisfactory
Very good
Excellent
Physical health, rest, well being
Friends & family
Home environment
Career: personal growth & fulfillment
Career: interpersonal relationships
Financial
Fun, recreation, leisure
Community connection
What are 3 things you want to do most? (short term, mid term, long term) *
Describe your 3 greatest accomplishments? *
What are the 3 most positive things in your life? *
What energizes you to wake up and get going each day? *
What keeps you up at night? *

Using quick statements or a single words to describe your self  - what is seen from your "resume"? 

Using quick statements or a single words to describe your self  - what do people that are closest to you see? 

Using quick statements or a single words to describe your self  - what do people normally not see? 

What do you need most from me during our time? *
Anything more you want me to know about you, your history, or anything else that is important? *
thank you!
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