LIFE COACHING PRE-SESSION ASSESSMENT
TOGETHER WE WILL EXPLORE:   **CHANGE**     ***POSSIBILITIES***    **HABITS**    ***MINDSET***  AND MORE - TO FULLY EMPOWER YOU WITH THE TOOLS AND EXPERIENCES OF LIFE COACHING.
Email *
NAME *
PHONE
HOW DO YOU PREFER TO BE CONTACTED?
Clear selection
HOW DO YOU PREFER TO RECIEVE COACHING? *
WHAT AREAS OF YOUR LIFE WOULD YOU LIKE TO IMPROVE?
WHAT ARE YOUR PRIMARY GOALS IN WORKING WITH A LIFE COACH?
IF YOU COULD ACCOMPLISH ONE GOAL THROUGH LIFE COACHING, WHAT WOULD IT BE? *
ON A SCALE OF 1 TO 10, HOW IMPORTANT IS ACHIEVING THIS GOAL TO YOU?
A LITTLE BIT...
HOUSE ON FIRE IMPORTANT!
Clear selection
WHY IS NOW THE TIME TO FOCUS ON THIS GOAL?
ON A SCALE OF 1 TO 10, HOW COMMITTED ARE YOU TO ACHIEVING THIS GOAL? *
A LITTLE BIT...
HOUSE ON FIRE COMMITTED!
WHY ARE YOU LOOKING FORWARD TO COACHING? *
WHAT ARE YOUR TOP 3 GREATEST SUCCESS MOMENTS IN LIFE? *
WHAT IS MOST IMPORTANT TO YOU IN LIFE RIGHT NOW? *
ON A SCALE OF 1 TO 10, HOW STRESSED DO YOU FEEL RIGHT NOW?
A LITTLE BIT...
TREMORS!
Clear selection
WHAT ARE YOUR KEY STRESSORS?
ON A SCALE OF 1 TO 10, HOW WOULD YOU RANK YOUR HEALTH RIGHT NOW?
TERRIBLE!
FEEL LIKE I'M 20 AGAIN!
Clear selection
ON A SCALE OF 1 TO 10, HOW DO YOU FEEL ABOUT YOUR SCHEDULE, TIME USE, AND OVERALL BUSY-NESS?
STUCK IN THE MUD!
CARE FREE!
Clear selection
IS THERE ANYTHING ELSE YOU WOULD LIKE TO SHARE OR SPECIFIC QUESTIONS YOU HAVE?
WHAT WOULD YOU LIKE FROM YOUR COACH DURING YOUR SESSIONS:  *
Required
PLEASE REVIEW THE DISCLAIMER/CLIENT AGREEMENT AT THE BOTTOM OF THE PAGE HERE: https://www.ZACHKEYER.com

PLEASE TYPE YOUR FIRST AND LAST NAME BELOW AS YOUR SIGNATURE IF YOU AGREE
*
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy