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Questionnaire for your Coaching Strategy Session

Goal:  To help you reach heightened levels of clarity, energy, courage, productivity and influence on your march to a successful, healthy, and fully charged life.

Instructions:  Please answer the questions below and on the following pages to the best of your ability and email or fax your responses to me before our call.

 

Source:  This tool is based on proprietary concepts from High Performance Institute's Certified High Performance Coaching Program™.  Do not duplicate or distribute without permission.

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Question 1 of 35

Your full name:

Question 2 of 35

Phone Number:

Question 3 of 35

Address:

Question 4 of 35

City, State Zip

Question 5 of 35

Country:

Question 6 of 35

Email:

Question 7 of 35

Occupation:

Question 8 of 35

Date of Birth:

Question 9 of 35

Gender:

A

Female

B

Male

Question 10 of 35

Marital status

A

Married

B

Single

C

Divorced

Question 11 of 35

Please briefly describe how you heard about my coaching services and why you would like a Strategy Session with me.

Please rate yourself

Please rate yourself in the following areas of your life on a scale of 1 (lowest) to 10 (highest)

Question 13 of 35

Clarity:  Do you feel you are clear about who you are, your purposes, and the direction you want to go in life?

A

1

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

9

J

10

Question 14 of 35

Energy:  Do you consistently have enough mental and physical energy needed to excel, accomplish your goals, and feel motivated and happy?

A

1

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

9

J

10

Question 15 of 35

Courage:  Do you take action and consistently express who you truly are and what you truly think, need, and desire with the world?

A

1

B

2

C

3

D

4

E

5

F

6

G

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10

Question 16 of 35

Productivity: Are you consistently focused and effective, and are you good at minimizing distractions and maintaining priorities?

A

1

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

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10

Question 17 of 35

Influence:  Do you feel you have the social influence with your family, friends, and team needed to accomplish your goals?

A

1

B

2

C

3

D

4

E

5

F

6

G

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H

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I

9

J

10

Question 18 of 35

1. What do you do for a living and why did you choose that career?

Question 19 of 35

2. What are your top 3 goals you are striving to achieve right now?

Question 20 of 35

3. What major stressors or challenges are you struggling with right now?

Question 21 of 35

4. When you feel like your most successful and happy self, what makes you feel that way?

Question 22 of 35

5. What would your dream life look like if you could wave a wand and make it happen?

Question 23 of 35

6. What else has prevented you from having that dream life?

Question 24 of 35

7. What goal or dream have you ever given up on or failed at, and what do you believe caused you to stop or fail?

Question 25 of 35

8. What 3 big changes would you like to make in your life in the next 12 months?

Question 26 of 35

9. What are you most proud of and excited about in your life?

High Performance Questions

Your answers will help us focus our time and effort on what is most important to you.

Question 28 of 35

1. What negative recurring thoughts, fears, or behaviors would you like to overcome in order to feel more psychologically free, confident and successful?

Question 29 of 35

2. What eating, exercise or general health habits would you like to begin or break in order to feel stronger and more healthy physiologically?

Question 30 of 35

3. What distracts you the most from being more productive, and what major projects or missions are you struggling to complete faster and more efficiently?

Question 31 of 35

4. If you were more persuasive or influential, what dream or desire would you ask others to support you in achieving?

Question 32 of 35

5. When do you struggle to be fully present in your day or in any of your relationships?

Question 33 of 35

6. How purposeful do you feel in living each day, and how would you describe your purpose?

Question 34 of 35

7. Why would you like to work with a high performance coach?

Question 35 of 35

8. Why do you feel you would be a great student or coaching client if we worked together?

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