Life Coaching Pre-Intake Questionnaire
As a coach, it's important for me to understand how you view the world in general and yourself in particular. Each person has a unique way of thinking and a unique way of interacting with those around him or her.

Answer each of these questions as clearly and thoughtfully as possible, expressing the best of who you are.

These are "pondering" questions designed to stimulate your thinking in a particular way that will make our work together even more productive. Thank you for considering us!
Email address *
Client Full Name *
Your answer
Parent Full Name (if applicable)
Your answer
Phone Number *
Your answer
1) Which focus area do you want to participate in? *
2) What's the best time of day to call to set up intake? *
3) Describe why you or your student want/need coaching. *
Your answer
4) What do you want to make sure you get from the coaching relationship? (maybe write down 2 or 3 things that occur to you) *
Your answer
5) What are the 3 biggest challenges you are dealing with that has stopped your progress in life? *
Your answer
6) What 3 goals do you want to achieve within the next 3 months? *
Your answer
7) Do you believe in God or in the concept of a higher power? If so, describe the most useful and empowering aspects of your relationship with God. If not, what reference point do you use? *
Your answer
8) Life Coaching is an investment. Are you willing to commit to investing in yourself (financially) for the duration of the group? *
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