Coaching Interest Form
Thank you for taking the time to fill out this form.

You will receive a copy of your responses.

Within 48 hours you will also receive a link for an initial call to see if we are a good fit to work together.

Email address *
First Name *
Your answer
Last Name *
Your answer
Organization/ Company
Your answer
How did you hear about Akua
What do you do? *
How would you describe what you spend most of your weekdays doing? Are you a business-owner? Work for yourself? Team lead at a company? Employee on a sales team? Looking for new opporturnities?
Your answer
What excites you most about the potential of working together 1:1? *
Your answer
How are things going in your life and work? *
Your answer
What has been working? *
Your answer
What hasn't been working? *
Your answer
What would you want your life and work to look like in 6 months, 1 year? What would be different? What would you have wanted to accomplish? *
Your answer
Where do you think you might need to adjust to achieve what you want? *
Your answer
How do you want to feel after working with Akua? *
Your answer
Right now I *
I agree and understand that coaching is a process and I am willing to go on a journey to achieve what I want *
On a scale of 1-10, how committed are you to making a change to achieve your goals? *
Not Committed
Extremely Committed
Would you be interested in taking a highly validated personality/ leadership assessment to learn more about your strengths? *
Anything else you want to make Akua aware of?
Your answer
I am completing an International Coach Federation credential that requires I log my coaching sessions. No content of our session will be recorded. Only your name, contact information, and session duration will be noted. Your information will not be shared with anyone outside of a formal audit. Is that okay? *
A copy of your responses will be emailed to the address you provided.
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