Coaching Preparation Form – Interpersonal Wellness Services Inc

1. Identify one or two issues that is primarily on your mind?(Required)

2. List the challenges you have encountered around these issues(Required)

3. What is positive about the issue you are facing?(Required)

4. Which of the following would you like to address in coaching?(Required)

Painful conflict

Difficult relationship

Business/Career Challenges

Interpersonal skills

5. On a scale of 1 to 10 (1 being low and 10 being very high) how much fear or anxiety is this causing you?(Required)

1-3 low

4-6 moderate

7-8 high

8-10 very high

6. In which of the following are you seeking to grow or improve?(Required)

Money

Family

Intimate Partner

Change or renegotiate work relationship

Work or Career

7. Are you seeking to improve an aspect of your business, professional or personal life in one of the following time frames?(Required)

3-6 months

6-12 months

1 year or more

Other

8. Please identify the outcomes you would like from coaching below

9. Are you challenged with making decisions to move forward in a healthy way?(Required)

Yes

10. Do your need to set boundaries in a personal or professional relationship?(Required)

Yes

11. Are you willing to work with a coach to make these changes?(Required)

Yes

11. Do you want to free up energy, or reduce stress at home or work?(Required)

Yes

12. Are you in a transitioning stage in your life; such as divorcing, remarriage, a new relationship wanting to start over?(Required)

Yes

13. Do you need support, partnering, or a sounding board to help you make a life changing decision?(Required)

Yes

14. Do you need help coming to agreements, collaborating, building consensus, or making decisions at work or at home?(Required)

Yes

15. What do you desire in a coach or thinking partnership?(Required)

For clarity and focus

Not feel alone

Gain perspective

Celebrate my success

Gain accountability

16. If you did nothing about how you are living, working or playing out your life, what will be different in the next 6 months(Required)

Nothing

Things will be better

I won't be able to go on

It will be worst

17. May we call you to propose a coaching session? If so, what times are best for you?(Required)

18. What would you like to work on in your coaching sessions?(Required)

Anger Management

Interpersonal Skills Coaching

Conflict Coaching

Executive & Leadership Coaching

Wellness Coaching

Communication and Collaboration

Is your coaching sessions being sponsored by your organization?

Name(Required)

First Last

Please share the date and time when its best for our team to reach you to schedule your coaching session

Phone(Required)

Email(Required)

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