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Coaching Consultation Application
Welcome! Please answer these questions to qualify for a Coaching Consultation
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1
First Name
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First Name
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2
Last Name
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Last Name
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3
E-mail Address
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example@example.com
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4
Phone Number
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I will call this number at your scheduled appointment time.
Country Code (+1 for US)
Area Code
Phone Number
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5
What interested you in having a coaching consultation with me?
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6
What is the main area of struggle or concern in your life right now?
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Business and/or Career
Health and Well-Being
Time and Money Freedom
Love and Relationships
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7
Rate your satisfaction with your current results in the following areas:
*
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Business and/or Career
Time and Money Freedom
Health and Well-Being
Love and Relationships
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Health and Well-Being
Love and Relationships
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8
Describe the #1 challenge you would like to address during your coaching consultation.
*
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Challenging times hold the opportunity for our evolution, if we are open. I invite you to take a deep breath and reflect on the main area of struggle you selected above. Describe your problem in as much detail as you would like. Your honesty in this reflective process will help you gain clarity as you move forward.
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9
What have you been doing to address your #1 challenge?
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10
How long has this challenge been going on?
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Has it been months? Years? Decades?
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11
If you could resolve your #1 challenge and live a life you LOVE, what would that look like? What would it feel like?
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Describe your ideal life in detail. Use your imagination and dream BIG!
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12
Have you done any personal development work previously? If so, describe your experience with it.
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Share your experience with personal development books, courses, coaching, seminars, etc.
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13
On a scale from 0-10, with 10 being 100% ready, how ready are you to invest in changing your results in your main area of struggle, on a mental, physical, and emotional level?
*
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I'd prefer to stay where I am for years
I'm ready to commit to change NOW!
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14
On a scale from 0-10, with 10 being 100% ready, how ready are you to invest in changing your results in your main area of struggle, on a mental, physical, and emotional level?
*
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Rate your level of readiness from "Not at all" to "Yes! I am ready NOW!"
Not at all Ready
Somewhat Ready
Mostly Ready
Yes! I am ready NOW!
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15
Up until now, what do you think has kept you from experiencing optimal results?
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What do you think is the REAL, underlying reason you are dissatisfied right now?
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16
Capitalize on your coaching call with these power moves:
Be on time
for our call. Please be ready to receive a call at your scheduled appointment time.
Settle into a
quiet space
, so you and I can bring uninterrupted, laser focus to your optimal solution.
Have a notebook handy. We will discuss several strategies, and you will be thankful you came ready to
take notes!
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