Coaching Pre-interview Form
This form is intended to determine whether a prospective client will be a good fit for coaching with Jack.  It is suggested you deeply consider these questions and notice whether any resistance comes up for you and, if so, if you would be willing to commit to overcoming those reservations in service to your greater vision. 

Thank you for your interest. We look forward to receiving your responses. 

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Why are you interested in hiring a coach at this time? *
What led you to Jack? *
What has you interested in coaching with Jack? *
Do you consider a Coach a luxury or a necessity? *
On a scale of 1-10 how willing are you to surrender to the process even when it requires you to do uncomfortable things? *
Not willing at all
Absolutely willing
What would you say are your three biggest challenges right now? *
Do you have a history of alcohol or drug abuse? *
Required
If you answered yes to the previous question, please elaborate. *
Do you have any of the following  *
Required
Are you currently or have you previously been in therapy? *
Required
Name three things you are committed to accomplishing. *
Why are you here? *
When you exit this world how would you like to be remembered? *
Have you got something to prove? If so, what? *
Are you happy with who you are? If not, where would you say you fall short? *
Are there any links you can share that would demonstrate the way you present yourself to the world? These could be related to your work and/or your persona.  *
Is who you are being in this moment who you want to be? *
Thank you for taking the time to complete this form.
Each coaching contract is uniquely tailored to the individual. 

If you are offered a contract you will be asked to commit to yourself in a way you've not done previously and your commitment will be matched by the level of support you will receive. 

If upon reviewing this form I believe you would be a good fit for this work, you will be invited to an in-person interview or a video call where together we will determine if 1:1 coaching would make sense for you at this time or I may suggest an alternative I believe would be of benefit to you.. 

I look forward to reading your responses!

Respectfully,  Jack 
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