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OPPC Client Intake Questionnaire
Welcome to On Purpose Planning & Consulting - Please fill out our survey below...
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1.
Today's Date
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Date / Time
Date
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2.
Contact Info
(Required.)
Name
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Company if Applicable
Address
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Address 2
City/Town
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State/Province
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ZIP/Postal Code
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Country
Email Address
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Phone Number
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3.
Enneagram & Coaching Client ONLY
Copy Link, complete the assessment, then come back and enter your top 3 number results by percentage % below, as well as email me your results (onpurposeplanningandconsulting@gmail.com):
https://assessment.yourenneagramcoach.com/
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4.
Tell me in a sentence or two about what you're looking to receive from this coaching experience.
Do you need assistance working through a current problem? Help determining immediate next steps in your life?
Guidance through everyday maintenance of life?
(Required.)
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5.
What are the Top 3 Significant goals you would like to achieve?
(Required.)
Describe your specific goal 1...
Desired outcome/result...
Describe your specific goal 2...
Desired outcome/result 2...
Describe your specific goal 3...
Desired outcome/result of goal 3...
6.
What are your targeted needs?
Self Improvement & Awareness through Enneagram Coaching
Effective Communication & Engagement Skill Coaching
Relationship Management through creation of Boundaries, Expectations, and Accountability Coaching
Personal Leadership & Development - Lunch & Learns, Masterminds, and Coaching/Mentoring
Root Discovery (Getting to the root of your issues) - Critical Coaching
Continuous Improvement Consulting
Strategic Life Planning/Goal Planning
Group Coaching & Training
Other (please specify)
7.
What is your desired method of connection?
Coaching Membership
1X Coaching Session
Group Coaching
Mastermind Group
Lunch & Learn
Full Day Workshop
Half Day Workshop
Course Curriculum Development
Speaking Engagement/Ted Talk
Retreat/Conference (Multiple Day)
Other (please specify)
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8.
Do you have specific watchouts in regards to the questions below?
(Required.)
Risks that could prevent success?
Opportunities that could impede progress?
Threats that could derail the process of coaching, training, goal attainment?
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9.
Please share some personal expectations around the framing of this working relationship...
(Required.)
When would you like to begin coaching?
When would you like to achieve the set out goals above?
What's your current coaching budget, either monthly or in its' entirety?
Where do you prefer to have meet ups?
Choose a place within Cranberry, Wexford, Beaver, McCandless, or Pittsburgh
Face-time and Skype also available
Fee Schedule available for extended, out of state Travel
Is there any other info you think I need to know before we move forward (Please Specify)
Current Progress,
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