Congratulations and welcome to

Yes U are  
Life coaching for intense women like you

  by Neri L. Choma

    Please print the following questionnaire and allow the time to answer these questions prior to out first coaching session. This will allow me a better understanding of who you are and what are your needs, so that we will get to work right away.  Please bring it with you to our first coaching meeting,  or mail it to my office .  

I look forward to coaching you.    

                                                    

 

 Name: ___________________________________

Mailing address: ___________________________

E-mail address: ____________________________

Home phone: _____________________________

Cell phone: _______________________________

Marital status: M   S   D    children:  Y/N      If yes names and ages: ______________________________________________________________________________

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1.  How did you hear about me?

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2.  What made you decide to work with a coach at this time of your

life?

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3. What do you want from this coaching relationship?

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4.  Rate yourself on your level of satisfaction in the following areas of your life:

 (1) no satisfaction    (2) minimal satisfaction    

 (3) satisfied                (4) very satisfied

 

________Your professional life

________Your marital/romantic relationship

________Your social relationships ­­­­­­­­­­­­­­

________Your family relationships

________Your physical body- health and shape

________Your financial and material situation

________Your self growth

________Your spiritual connection

 

5.  In what ways are you ‘stuck’ right now in your personal life?

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6.  In what ways are you ‘stuck’ right now in your professional life?

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7.  If you couldn’t fail, what are the 3 goals you most want to accomplish in your personal life in this lifetime?

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8.  What might get in the way of this coaching relationship?­­­­­­­­­­­­­

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9. How can I best support you through the ups and downs you will experience in your journey?______________________________________________________________

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10.  What moves you in life? What gets you really excited and

passionate?

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11. What was one peak experience in your life? What were you

doing?  Who were you with? Why was the event so special?

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