Tell Me About You!

First, I'd like to applaud you for your interest in making significant positive changes in your life!  I am honored that you are interested in working with me as your coach.  These short questions are designed to help me assess your readiness for coaching and determine if we would be a good fit for each other. Also, by briefly answering these questions, you are demonstrating that you are indeed ready to commit to yourself and your personal and/or professional growth (congratulations, that's a very good thing!).  Please know that anything you write here is seen by my eyes only and will be kept absolutely confidential. (Tip: please scroll down first to Question 8, which lists some budget options for programs. If your answer is "none of the above", unfortunately I do not have any program options available for you at this time and suggest that you skip filling out the rest of the questionnaire - I don't want to waste your valuable time!). If the ranges fit your budget and you fill out the questionnaire in full,  I will usually be able to get back to you via email in 1-2 business days. Thank you!! - Dr. Susan

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* 1. Please enter your basic contact information below:

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* 2. What made you decide that you would like to work with a coach at this point in your life? (Did something happen recently that convinced you that you need to make some significant changes in your life?)

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* 3. Why would you specifically like to work with me?

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* 4. What are three primary results you would like to see in your life or yourself as a result of working together? (Be brief, describe each result in one short sentence or phrase)

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* 5. How soon would you like to get started with your coaching program? (i.e. when would you ideally like to get started with your first session?)

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* 6. What kind of a timeline are you ready to commit to for your development and progress? i.e. would you be available to meet three times a month by phone, for the next 6 months?  If not, what type of program (frequency of sessions etc.) would work best for you?

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* 7. Have you worked with a coach or other professionals in the past to help you reach your goals? (e.g. a personal trainer, counselor, nutritionist, business strategist etc.)

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* 8. Which of the following ranges best fits your monthly budget for coaching? (select one from the dropdown menu)

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* 9. What days and times during a typical week (Monday to Friday) are best for you to meet by phone for your sessions? (Please include your time zone)

Thank you so much for taking the time to tell me about you, I will be in touch soon to follow-up with you!

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