Coaching Onboarding Questionnaire

Personal Information

Please take the time to fill out this onboarding questionnaire. We look forward to working with you.

First name

Last name

Street Address

City, State, Zip Code

Phone

Date of Birth

Month

Day

Year

Gender

Referred by

Occupation

Hours working per week

Relationship status

Number of children, if applicable

Describe your formal and informal education

Client Goals

1. What are your short-term goals? Where do you see yourself in one year?

2. What are your long-term goals? Where do you see yourself in 3 years?

3. Rate your level of commitment to improving your level of wellbeing. 1 = Lowest & 10 = Highest

Your Life

4. List your current life concerns in order of importance (1-5)

5. When you think of your life, what has been your biggest success?

6. What did you do to accomplish it?

7. What has been your biggest challenge and what did you do to get past it?

8. If not, what was the barrier?

9. Where do you get your energy? Your motivation?

10. Rate the quality of work life on a scale of 1-10. 1 = lowest & 10 = highest

11. Rate the quality of personal life on a scale of 1-10. 1 = lowest & 10 = highest

12. Looking at the last six months of your life, do you like the direction it is going in? Why or why not?

Your Lifestyle

13. Describe your ideal day.

14. How would you describe the level of stress are you under?

15. Please provide any other information that may be relevant to how you are feeling day-to-day.

16. What are the most and least favorite parts of the day?

Coaching Assessment

17. When looking back on the last year, how satisfied are you with these areas of your life on a scale of 1-10 (1 = unsatisfied & 10 = totally satisfied)

Overall Wellbeing / Life Satisfaction

Physical Health

Stress Level

Mindfulness

Physical Activity

Essential Medical Care

Nutrition

Sleep Habits

Alcohol and Drug Use

Neurocognitive Stimulation (hobbies, activities, learning, games, new material, etc.)

Social Connections

Emotional Balance

Relationships

Spirituality and Life Purpose

Family

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

Your Transformation Begins...

19. If we could create anything during the course of our work together - transformations in any areas of your life, health, relationships, etc - what would we create?

20. List the key goals you have for our coaching process and what your measures of success would be.

21. How will you know when you are receiving value from the coaching process? What do you most need from coaching?

22. What are the three changes to make in a week to get you off to a good start in our coaching?