Discovery Form Life Coaching Questionnaire Name * Email * Phone * Work Phone Home Phone Birth Date Spouse's Name (If applicable) No. of Children Anniversary Date (If Applicable) Please complete as much of the following as possible. If you are unsure of any of these answers, don't worry as we will work on these things together anyway. YOUR GOALS What is the main reason or primary goal for your life transition? Name 5 goals you would like to achieve in the next 90 days What are the 3 biggest changes you would to make in you life over the next three years? PERSONAL HISTORY What would you say have been your three greatest acomplishments in your life to date? What is the hardest thing you have ever had to overcome? Who are or have been your top 5 role models? What major transitions have you had in the pas to two years? (i.e. new job, new stage of life, new residence, separation/divorce, death of a loved one, birth of a child, marriage, etc. YOUR LIFE Is your life of your choosing? If not, which parts are being chosen for you? On a scale of 1-10, 10=High, provide a number that represents the current level/degree of stress: * What are your primary stressors? What are the top 5 things you are facing right now that need immediate focus or resolution? STRENGTHS What are the top 5 personal and professional qualities that you have that help you succeed (e.g. dependabiltiy, creativity, communication skills, etc.)? BLOCKS AND WEAKNESSES What is it about you that stops you or makes it difficult for you to meet or exceed goals? Your values are the qualities of life that you find most attractive. They are expressions of YOURSELF and allow you to feel truly fulfilled. What do you feel are your deepest values? If this is not now clear for you , leave this blank for now. ( e.g. Relationship with God, honesty, adventure, family, etc.) What would you like to contribute to the world? What is a dream or goal you have given up on? COACHING RELATIONSHIP What would you expect or like your Coach to do if you decide to get behind you goals? How will you know when you are receiving value(i.e. your money's worth) from your Coaching relationship process? New reCAPTCHA
