Coaching Pre-Work
This questionnaire will serve as an opportunity for me to get to know you better and to help make your time as effective and meaningful as it can possibly be. Please read the following questions carefully and answer them thoughtfully. Please feel free to answer as honestly as possible; your responses are kept strictly confidential!
If you have any questions please email Kristi at support@koelleinstitute.com
Email address *
First and Last Name *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
General Information
What inspired your decision to seek a coaching experience? *
Your answer
Please feel free to share whatever you feel comfortable expressing about your childhood upbringing. How do you currently feel about it? What was/is your relationship with each of your parents (or grandparents, caretakers) like. *
Your answer
How do you tend to spend most of your days? Do you work? Are you a student in school? Are you a stay at home parent? On a scale of 1 to 10 how fulfilled do you feel by the work that you do or how you spend most of your time? Please explain. *
Your answer
If you are currently in a romantic relationship (dating, married, divorced, etc.) please describe this relationship from your perspective and how you feel about it.
Your answer
If you are currently single please share a little bit on how you feel about it.
Your answer
What are 3 events or experiences that have been happening in your current life that you are enjoying? *
Your answer
What are 3 events or experiences that have been happening in your current life that you feel are stressful or that are challenging you? *
Your answer
Have you had any traumatic experiences that you would like me to know about (ie. sexual abuse, physical abuse, verbal abuse, witnessing traumatic events etc.) Please only write what you feel comfortable sharing. If you would rather not say please leave this blank.
Your answer
Have you been having any health challenges that you would like me to be aware of? *
Your answer
Leadership & Communication Style
What do you feel are your areas of strength in your style of communication? *
Your answer
What do you feel are your areas of weakness in your style of communication? *
Your answer
Can you describe 3 names or situations whom you have the most difficult time communicating with and explain from your perspective why you think this is the case? *
Your answer
Additional Information
Do you have any additional concerns or questions regarding this experience? *
Your answer
Is there anything further you would like to mention here that you feel is relevant?
Your answer
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