Congratulations on taking a very important step in your life!

This questionnaire contains some powerful questions for you to consider before your first
coaching. This tool is meant to empower you to think clearly, become intentional and allow
yourself the privilege to look for the answers. Think about what you want, what limitations you’re
currently living with, and how you can move forward into the life you desire living.

To make the most of this session, I invite you to find 45 min to 1 hour where you can have an
appointment with yourself, uninterrupted. Find an environment that is relaxing, pleasing and
allows you to be at your best, 100% focused on yourself. Give yourself the gift of time. Allow your
answers to come from your whole engaged being.

Use this tool anyway you would like. Take some time to ponder the questions, answering all the
questions or choosing not to.

I hope that you will make a choice to be open to all possibilities.

YOUR GOALS:

What 3 changes do you most want to make in your life?

What are you tolerating in your life at present? (Examples: clutter, overdue bills, job
dissatisfaction, dead plants, overeating, broken equipment, etc.)

YOUR SELF:

What 5 adjectives would someone use to describe you at your best? (in no particular order)

What 5 adjectives would someone use to describe you at your worst? (in no particular order)

What five adjectives would you use to describe yourself at your best?

What five adjectives would you use to describe yourself at your worst?

What concerns do you have about life?(required)

What causes you to feel motivated?(required)

YOUR VISION & POSSIBLITIES:

What is your personal and/or professional vision?(required)

What intentions do you have for your life presently?(required)

If you could achieve at least 1 goal from our coaching sessions, what would it be?(required)

On a scale of 1-10 (10 high), what is the quality of your life today?(required)

THANK YOU!

Please press send to email this document to me.