Coaching Clients, complete this form first.
Hey there!

Thanks for your interest in working with me or one of our amazing executive coaches at Leverette Weekes. To help you get started quickly, tell me more about who you are, who you want to be, and what's holding you back.

I'm here to help you overcome imposter syndrome and mental burn out to achieve your motivating career goals. Over the last four years, my coaching practice has quickly gained a loyal following.

Step 1: The TRIBE methodology starts with goal setting and getting clear about what you want.
Step 2: Next, we'll shift your mindset and your language to align your time.
Step 3: Finally, we coach you to take your action steps to have a positive impact on your confidence and organization.

The Getting Unstuck program is designed to help leaders and entrepreneurs like you, create the life you want.

Once you complete your form, you'll receive a link to schedule a time to meet with one of our coaches and learn more about the coaching format, International Coaching Federation guidelines, and answer your questions about the program.

It's important to note your responses are kept confidential and are only used to help me prepare for your session.

- Meredith Moore, communications lead, executive coach, and author of Getting Unstuck: A Guide to Moving Your Career Forward.
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Email *
Name *
Have you worked with a coach before? What worked? What did not work?
Have you recently completed your Insight Discovery profile to understand your strengths, blind spots and value to your team?
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What goals do you want to achieve in the next three months? *
What skills or education do you need to develop to achieve your goal?
Do you plan to stay at your company in your current role for the next 5+ years? *
What have been your three most fulfilling accomplishments/achievements in life, thus far? *
What has made you successful or powerful? (If you don't feel successful or powerful, tell me why)
What should I know about your PROFESSIONAL background or history? What experiences have helped you grow or held you back?
Are you currently responsible for managing others? *
What was the biggest obstacle you have had to overcome? *
What should I know about your PERSONAL background or family history?
How have your attitudes about people and life changed over the past 10 years?
How does your manager support your development? *
Have you experienced any of the following in the last 12 months at work?
Can you think of a time you felt like you failed, and how has that affected the way you think and act today? *
Do you have any mental health challenges such as depression, bipolar disorder, anxiety or other challenges that have affected you? Are you currently under the care of a mental health professional? (Note if you'd like a referral to a culturally sensitive care provider)
Is there anything else you would like to share with your coach?
Thank you for your interest in Getting Unstuck coaching with Meredith Moore!
Your responses will be reviewed. Check your email for more information. If you need immediate assistance please contact our office at 844-765-1601 or
A copy of your responses will be emailed to the address you provided.
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