Performance coaching form

Personal Performance Coaching Questionnaire

This performance coaching questionnaire is designed to maximize the value of your upcoming free 30-minute discovery session.

By providing insights into your goals, challenges, and expectations, we can tailor our conversation to better suit your needs and outline a clear path forward.

Your responses will help us understand where you are in your personal and professional journey and how our coaching services can best support your growth and success.

Please take a few moments to complete this questionnaire thoughtfully.

We look forward to discovering how we can work together to achieve your aspirations.

Full Name

Email *

Phone *

What are the TOP 3 goals that you want to achieve over the next 6 months?

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

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.)

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 (5) 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.)

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)

Strategic planning
Accountability, checkink up on goals
Directness, asking hard questions. Challenging you to move forward.
Exploring and removing blocks and obstacles to your success
Brainstorming strategies together
Insgiht into who you are and your potentials
Painiting a vision of what you can become and accomplish
Working through self-improvement programs together
Suggesting or designing action steps
Support, encouragement, validation

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:

What is your favorite color?

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