Strategy Session Signup — COACH HABIT LLC
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About
Services
Contact
Connection Counts
Questionnaire for your
Free Sample Coaching Session
Name
First Name
Last Name
Phone Number
(###)
###
####
Address
City, State, Zip
Country
Email
Occupation
Date of Birth
MM
DD
YYYY
Questions:
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Please briefly describe how you heard about my coaching services and why you would like a Strategy Session with me:
Please rate yourself in the following areas of your life on a scale of 1 (lowest) to 10 (highest):
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Clarity:
Do you feel you are clear about who you are, your purpose, and the direction you want to go in life?
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Energy:
Do you consistently have enough mental and physical energy needed to excel, accomplish your goals, and feel motivated and happy?
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Courage:
Do you take action and consistently express who you truly are and what you truly think, need, and desire with the world?
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Productivity:
Are you consistently focused and effective, and are you good at minimizing distractions and maintaining priorities? *
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Influence:
Do you feel you have the social influence with your family, friends, and team needed to accomplish your goals?
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10
1. What do you do for a living, and why did you choose that career?
2. What are your top 3 goals you are striving to achieve right now?
3. What major stressors or challenges are you struggling with right now?
4. When you feel like your most successful and happy self, what makes you feel that way?
5. What would your dream life look like if you could wave a wand and make it happen?
6. What else has prevented you from having that dream life?
7. What goal or dream have you ever given up on or failed at?
8. What 3 big changes would you like to make in your life in the next 12 months?
9. What are you most proud of and excited about in your life?
10. Why would you like to work with a high performance coach?
Thank you!
