Coaching Survey

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Coaching Survey

Thank you for reaching out to Living Life On Target. Please be honest with yourself to identify all that apply to you currently or within the past 12 months. This insight will assist us in identifying and determining our path forward together.

Email *

First & Last Name *

Company and Role *

Best number to reach you: ___-___-____ (Cell/Office/Home) Ex: 706-111-1111 (Cell) *

Today's date *

YYYY

Initially, I am pursuing individual coaching because... *

Emotional Intelligence (Check all that apply.) *

I have a tendency to become negative and have an outlook of limitation.

Managing with stress by applying techniques personally and professionally would help me.

I am not very motivated to take action.

A better understanding of what is holding me back would be of benefit.

I could benefit from greater self awareness and its impact on others.

Self sabotage (directly or indirectly) is a concern of mine.

I have a hard time of letting go of negative situations.

I am critical of myself and others.

I lose my cool when I get frustrated or someone catches me off guard.

Required

Communication (Check all that apply.)

Recognizing verbal or nonverbal communication isn’t always easy.

I could use better wording and/or actions to increase credibility and influence.

Handling difficult questions can fluster me and is overall difficult

I need to improve my ability to present ideas persuasively.

Confidently projecting my message would increase credibility.

I need to learn a structure to tell stories to grab and keep the attention of our audience.

Learning to communicate through the difficult times would be of benefit.

I could gain greater buy-in by simplifying my message.

I need to learn how to put my thoughts into a message to inspire and motivate others.

Time Management (Check all that apply.) *

I often procrastinate causing me to cram last minute.

I often miss deadlines and have trouble prioritizing tasks.

I need to be improve my ability to manage my priorities and accountabilities.

I want to make meetings more efficient and productive.

Being better prepared for meetings would help me build confidence and credibility.

I usually run late to my appointments.

Required

Leadership (Check all that apply.) *

I need to collaborate more for win-win solutions.

Coaching others is sometimes a struggle.

Transitioning from friend to boss has been a difficult journey.

I need management fundamentals: delegation, accountability, planning, and problem solving.

Strategic vs tactical - It's diffult for me to lead in one or both of these ways.

Required

People Skills (Check all that apply.) *

I sometimes have unhealthy conflict when tensions get high.

It is hard for me to get past conflict.

Taking the time to build trust to develop strong relationships could have a big impact on my/our success.

Understanding how to adapt to different personality or communication style can be of benefit.

Bridging generational gaps could help me work together with others more effectively.

I need to focus more on my team and their success rather than my individual success.

Required

Team Building (Check all that apply.) *

My team is not a high performing team; it's sometimes dysfunctional.

I need to focus more on my team and their success rather than my individual success.

We need a unified team to work together more effectively.

There has been a lot of change within my team within the last 1-2 years.

Developing goals, values, and a vision is an important next step.

Required

Do you give your permission to share the above responses with your Manager or Mentor? *

Yes

As a result of coaching, I want/need/desire to...

Other:

How did you hear about Living Life On Target? *

Manager/Mentor

Linked In

Facebook

Friend

Family Member

Diane Vinyard

Other

A copy of your responses will be emailed to the address you provided.

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