IDG Vision Consulting & Training Coaching Intake Questionnaire

1-on-1 Coaching Participant Profile

Please take time to answer the questions on the following pages. Some of the questions capture information about where you are today. Others will get you thinking about what you want from coaching, from your job, and from life in general. This information will set a good foundation and allow us to move forward.

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* 1. Personal Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Work Information

Job Title

Years with Company

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* 3. Coaching. What do you want to ensure you get from the coaching relationship? What specific outcomes are you seeking?

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* 4. Coaching. How can I best support you as a Coach?

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* 5. CAREER

What do you want from your job?

What projects are you leading?

What are you key job goals?

What skills or knowledge are you developing?

How do your job goals support your personal goals?

What else can you do to advance the company’s objectives?

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* 6. PERSONAL

What do you have to contribute that is unique?

What special knowledge do you have?

What do you believe in?

What do you do when you’re really up against it?

What activities have meaning and heart for you?

What needs in the world are you moved to meet?

What two steps could you take immediately that would make the greatest difference in your current situation?

What can I say to you when you are most ‘stuck’ that will return you to action?

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* 7. Wheel of Life Exercise. Which area(s) of your life are you MOST satisfied?

Career

Money

Health

Friends and Family

Significant Other / Romance

Personal Growth

Fun and Reaction

Physical Environment

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* 8. Wheel of Life Exercise. Which area(s) of your life are you LEAST satisfied?

Career

Money

Health

Friends and Family

Significant Other / Romance

Personal Growth

Fun and Recreation

Physical Environment