EMAIL
First Name
*
Email Address
*
Phone Number
How long have you been in the work force?
Less than a year
1-3 years
3-5 years
5-10 years
10 or more years
What do you hope a coach will help do for you?
Clarify your career/work goals?
Improve speciFc behaviors or methods for work?
Improve your current work situation?
Make a "graceful and productive" exit from work?
Work on stress reduction and self care?
Reduce obstacles and barriers to moving ahead in your personal pursuits?
All of the above
Check all that apply.
What soft skills would you like to improve in coaching?
Leadership
Listening
Compassion/Empathy
Engagement
Communication
Problem Solving
Team Building
Time Management
Persuasion/Buy-In
Seeking Feedback
ConVict Resolution
Delegating
Decision Making
Mentoring
Emotional Intelligence
Critical Thinking
Networking
Check all that apply
What 3 short-term goals would you like to accomplish over the next 6 months?
Why are these goals important to you?
What previous steps have you already taken to achieve your goals? What has been the result so far, and what have you learned?
What current challenges do you think may be preventing you from achieving your goals and desired outcome?
On a scale of 1 to 10, how would you rate your current stress level?
1
2
3
4
5
6
7
8
9
10
What is causing you stress? What do you do to manage your stress?
What has been your biggest success in your life thus far? How did you achieve it?
In a few words explain what your desired outcome from a coaching partnership would be.
In a few words explain what your desired outcome from a coaching partnership would be.
If you could project out 1 year, what would be your ideal situation?
Is there anything else that you'd like the coach to know about you? Do you have any questions for your coach?
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