Name
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First Name
Last Name
Email
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Phone
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Preferred Contact Method
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What services are you interested in?
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What is your current occupation, business, or role?
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What are your top 1-3 goals for your life or career right now?
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What challenges or obstacles are preventing you from achieving these goals?
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On a scale of 1-10, how committed are you to making changes to achieve your goals? (1 = not committed, 10 = fully committed):
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Have you ever worked with a coach or mentor before? If yes, what was the experience like?
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Why are you considering coaching at this time?
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What qualities do you hope your coach will bring to this relationship? (e.g., accountability, empathy, strategy, etc.)
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What is your preferred coaching style? (e.g., direct and no-nonsense, collaborative and supportive, structured and goal-oriented):
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Is there anything else you’d like me to know about you or your situation before we begin?
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