Are You Coachable?
Ready to Commit to the Journey for the Next Level
* Required
Name
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Your answer
Email
*
Your answer
City
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Your answer
State
*
Your answer
Gender
*
Male
Female
Required
1. I am ready to make a change in my life now
*
Yes
No
2. I am ready to make sacrifices to reach my goals
*
yes
no
3. I have time to invest in myself (30 min per week)
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Yes
No
4. I am willing to try new concepts, even if they feel outside of my comfort zone
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yes
no
5. I am ready to develop the parts of myself that I once dismissed or ignored
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yes
no
6. I am open to exploring healthy ways for communicating
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yes
no
7. I see coaching as a valuable investment in my life
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yes
no
8. I am willing to work through my problems and give up blame
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yes
no
9. I am willing to be honest with myself and my coach
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yes
no
10. I am willing to take constructive feedback and learn from it
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yes
no
11. I am willing to challenge my thoughts, feelings and actions if they are hindering my progress
yes
no
Clear selection
12. I am open to trying personal reflection techniques
*
yes
no
I would like to receive more information from you for coaching purposes
*
yes
no
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