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Intake Coaching Questionnaire

Please take a few minutes to fill out this coaching intake form.

Note we consider only attendees that have completed the questionnaire for the FREE group coaching session, as our coaches need the information to prepare in advance.

Be reassured we will keep your data strictly confidential. Our coaches all sign confidentiality clauses and adhere to the International Coaching Federation Code of Ethics.

Upon completion you will receive an email with the link to your results, but just in case do export and copy the results yourself as well. Thank you!

Click the button below to start.

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Question 1 of 11

What's your name?

Question 2 of 11

 

If you’d have to choose just ONE of the below statements, which one has your #1 focus/priority RIGHT NOW?

A

I want to feel in control and feel secure

B

I want to be challenged by something new

C

I want to feel important, special and/or needed

D

I want to feel more connected with others and/or nature

E

I want to learn new things and grow

F

I want to make a difference in the world

Question 3 of 11

Your Unshakable Self in 2021:

 

Where does your Unshakable Self stand in life and business in 1 year?

 

Answer this question by reflecting on the following:

•             What do you see yourself doing by June 2021?

•             What have you achieved by June 2021?

•             What are you proud of by June 2021?

•             What are your biggest learnings by June 2021?

 

For this exercise it is best to think that it really is June 2021 and imagine you are looking BACK on the last year. Where are you ‘NOW’ (visualizing it is 2021)

Question 4 of 11

What are your biggest talents?

Use the following questions to reflect on your talents:

What skills do people acknowledge you for?

Looking at your greatest accomplishments, what did YOU DO / what talent did you use to achieve that?

Question 5 of 11

What type of coaching are you mainly interested in?

A

Executive Coaching

B

Leadership Coaching

C

Career Coaching

D

Business Coaching

E

Life coaching

Question 6 of 11

This session is FREE, but if you would have to pay, how much would you expect to pay for a group coaching session of 60 minutes?

A

USD 0-50

B

USD 50-100

C

USD 100-150

D

USD 150-200

E

USD 200-250

F

Over USD 250

G

not interested

Question 7 of 11

What is the ONE thing you would ask support from from our coach (coaching question)? What would be that # 1 thing be?

Question 8 of 11

On a scale from 1-10 (10= HIGH), how would you rate the quality of your life today?

Question 9 of 11

What is your expectation from the Coaching Call? What would you like to walk away with?

Question 10 of 11

What's your preferred day for the coaching session?

A

Wednesday 24th June

B

Thursday 25th June

C

Friday 26th June

Question 11 of 11

What's your emailaddress?

Confirm and Submit