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* 1. Your Full Name

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* 2. Phone Number

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* 3. Address

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* 4. Email

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* 5. Occupation

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* 6. Date of Birth

Date

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* 7. Gender

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* 8. Please briefly describe how you heard about my coaching services and why you would like a Strategy Session with me

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* 9. Please rate yourself in the following areas of your life on a scale of 1 (lowest) to 10 (highest)

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* 10. Clarity: Do you feel you are clear about who you are, your purpose, and the direction you want to go in life? (scale of 1-10)

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* 11. Energy: Do you consistently have enough mental and physical energy needed to excel, accomplish your goals, and feel motivated and happy? (scale of 1-10)

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* 12. Courage: Do you take action and consistently express who you truly are and what you truly think, need, and desire with the world? (scale of 1-10)

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* 13. Productivity: Are you consistently focused and effective, and are you good at minimizing distractions and maintaining priorities? (scale of 1-10)

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* 14. Influence: Do you feel you have the social influence with your family, friends, and team needed to accomplish your goals? (scale 1-10)

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* 15. What do you do for a living, and why did you choose that career?

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* 16. What are your top 3 goals you are striving to achieve right now?

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* 17. What major stressors or challenges are you struggling with right now?

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* 18. When you feel like your most successful and happy self, what makes you feel that way?

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* 19. What would your dream life look like if you could wave a wand and make it happen?

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* 20. What else has prevented you from having that dream life?

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* 21. What goal or dream have you ever given up on or failed at, and what do you believe caused you to stop or fail?

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* 22. What 3 big changes would you like to make in your life in the next 12 months?

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* 23. What are you most proud of and excited about in your life?

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* 24. What negative recurring thoughts, fears, or behaviors would you like to overcome in order to feel more psychologically free, confident and successful?

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* 25. What eating, exercise or general health habits would you like to begin or break in order to feel stronger and more healthy physiologically?

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* 26. What distracts you the most from being more productive, and what major projects or missions are you struggling to complete faster or more efficiently?

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* 27. If you were more persuasive or influential, what dream or desire would you ask others to support you in achieving?

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* 28. When do you struggle to be fully present in your day in any of your relationships?

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* 29. How purposeful do you feel in living each day, and how would you describe your purpose?

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* 30. Why would you like to work with a high performance coach?

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* 31. Why do you feel you could be a great student or coaching client if we worked together?

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