Coaching Questionnaire

Garbini Education and Career Consulting

Please type responses to all questions and click send to deliver to your coach. All information is PRIVATE and strictly CONFIDENTIAL.

First Name

Middle Name

Last Name

Phone

Date of Birth

Street Address

City

State

Zip Code

Country

How did you hare about me?

Search Engine Facebook Friend Other (Please note)

Goals

What are the three goals you want to achieve over the next three months?

What are the three biggest changes you want to make in your life over the next three years?

Personal History

What would you say have been your three greatest accomplishments in your life to date?

What is the hardest thing you have ever had to overcome?

Who are or have been your major role models?

What major transitions have you had in the past two years? (i.e. -- entering or approaching a new decade of life, a new relationship, a new job, a new role, a new residence, changes in children's ages/stages of life, separation, divorce, death of a loved one, birth of a child, marriage, etc.)

Your Life

Who are the key people in your life and what do they provide for you?

Is your life one 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 your current level/degree of stress:

What are your primary stressors?

List five things that you are tolerating or putting up with in your life at present. (i.e. -- Information you cannot find, rude people, poor lighting, tight shoes, dented car, job dissatisfaction, dead plants, broken equipment, old appliances, etc.)

Coaching You

What would you expect or like your Coach to do if you get behind on your goals?

How will you know when you are receiving value (i.e. -- your money's worth) from the Coaching process?

What types of approaches discourage you or take away your motivation?

How can your Coach best support you in the Coaching relationship? Using each number ONCE, place the following in order of importance. Rank using 1 - 10 (1 = Most Important; 10 = Least Important)

Brainstorming strategies together

Insight into who you are and your potential

Support, Encouragement, Validation

Exploring and removing blocks and obstacles to your success

Acountability; Checking up on goals

Working through self-improvement programs together

Suggesting or designing action steps

Painting a vision of what can become or accomplish

Strategic planning

Directness: asking hard questions; challenging you to move forward

Potential & Possibility

Do you have a personal or professional vision?

If so, what is it?

What would you like to contribute to the world?

What is a dream or goal you have given up on?

What part of yourself, if any, have you given up on?

On a scale of 1 to 10 (10 = HIGH), rate the quality of your life today: