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Group Coaching Survey
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Email
*
Your email
I’m creating a group coaching programs and I want to make sure it’s designed with
your
voice, needs, and dreams in mind.
This short survey will help me shape a space that is closely tailored to your needs.
By participating in this survey you will be added to an email list where you will be informed about upcoming coaching offerings. I do not send a lot of emails and I promise you will not be inundated with spam.
Your responses are completely
confidential
. Your e-mail will not be shared with any other party and all data, insight, and feedback will be kept in strict confidence.
Please share this survey freely with any individuals, groups, or organizations that you feel would be interested in participating.
What is your name or preferred alias
*
Your answer
What are your pronouns?
*
She/ Her/ Hers
He/ Him/ His
They/Them/ Theirs
Other:
How do you Identify?
*
Binary
Non Binary
Pangender
Agender
Other:
What is your age?
*
13-15
16-18
19-20
21-23
24-25
26-29
30-35
36-40
41-45
46-50
51-60
61-70
71+
1. What are the biggest challenges you’re currently facing in your life? Check all that apply.
*
Self-acceptance / confidence
Career or work-related challenges
Relationships / dating
Family dynamics
Medical transition / access to care
Mental health / emotional well-being
Navigating transphobia / discrimination
Other:
Required
2. In a supportive group space, what topics or themes would feel most meaningful for you to explore? Pick your top 3.
*
Building confidence & self-worth
Healthy relationships & communication
Coping with stress & anxiety
Dysphoria
Family dynamics & boundaries
Career, money, or purpose
Spirituality & meaning
Community & belonging
Other:
Required
3. In a sentence or two, describe the kind of growth you’d most benefit from.
*
Your answer
4. What helps you feel safe, affirmed, and empowered in group spaces?
*
Your answer
5. If you could make one major change or meet one specific goal by this date next year, what would it be?
*
Your answer
6. What stage of your social transition are you in?
*
1 year or less
1
2
3
4
5
6
7
8
9
10
10 or more years
7. What stage of your medical transition are you in? If not applicable, leave blank.
1 year or less
1
2
3
4
5
6
7
8
9
10
10 or more years
Clear selection
8. Are you seeing a mental health professional? (Select all that apply)
*
Therapist
Coach
In the past
Hoping to in the future
Required
9. How do you prefer group sessions to be structured?
( Select all that apply)
*
Learning from the coach with Q&A
Seeing someone else be coached and having the opportunity to be coached if desired
Guided exercises and activities
Open discussion and sharing
Receiving exercises and activities inside of and outside of sessions for self application
A mix of all the above
Required
10. What format would work best for you?
*
Weekly 1- hour sessions
Bi-weekly 90-minute sessions
Monthly 2-hour sessions
Other:
11.On a scale of 1–5, how interested are you in joining a group coaching program in the next 4-6 months?
*
Not at all interested
1
2
3
4
5
Very interested
If there is anything else that you'd like to share about your experience as a trans person or comments or suggestions you have about group coaching please share freely below.
Your answer
Send me a copy of my responses.
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