1. e-SIX LIFE COACHING QUESTIONNAIRE

The answers you provided will help us to understand what you might want to get from life coaching.

Please answer all questions including the contact details, without this information we may be unable to assess your eligibility.

GENDER

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* 1. GENDER

How positive do you feel about your future at the moment?

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* 2. How positive do you feel about your future at the moment?

  1. Not at all positive 2. 3. 4. 5. Neutral 6. 7. 8. 9. 10. Very Positive
Rate yourself on a scale of 1 - 10
What changes would you like to make in your life over the next 3 months?

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* 3. What changes would you like to make in your life over the next 3 months?

How confident do you feel that you could make these changes
without coaching?

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* 4. How confident do you feel that you could make these changes
without coaching?

  1. Not at all confident 2. 3. 4. 5. Neutral 6. 7. 8. 9. 10. Very confident
Rate yourself on a scale of 1 - 10
In what way do you want coaching to help you make these changes? (Please choose 4)

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* 5. In what way do you want coaching to help you make these changes? (Please choose 4)

What would make coaching successful for you?

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* 6. What would make coaching successful for you?

What long-term changes do you want to work towards?

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* 7. What long-term changes do you want to work towards?

Please tell us about yourself

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* 8. Please tell us about yourself

How did you hear about us?

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* 9. How did you hear about us?

Please tell us when you would you like your coaching sessions to take place

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* 10. Please tell us when you would you like your coaching sessions to take place

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

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