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Client Success Form
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Why have you hired me?
What is the most important objective you want to accomplish in the next 12 months?
What is the #2 important objective you want to accomplish in the next 12 months?
What is the #3 important objective you want to accomplish in the next 12 months?
What is the #4 important objective you want to accomplish in the next 12 months?
What is the #5 important objective you want to accomplish in the next 12 months?
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What would you like to accomplish during your lifetime (personally and professionally) so that you will consider your life well lived?
What is your passion in life or what makes you happiest and most fulfilled?
What are your favorite pastimes or hobbies (name at least 5)?
What motivates you or gives you energy?
What do you consider to be your personal and/or your professional strengths?
Tell me five (5) things in your personal/professional life, past or present, of which you are most proud.
Are you aware of any behaviors/beliefs that stand in the way of you achieving professional success and having the life you really want?
Tell me what else I should know about you so that I can best coach you.
How will you know that our coaching has been effective?
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I regularly increase my income by 20% or more each year.
Yes
No
Sometimes
I am well organized, focused, and highly effective.
Yes
No
Sometimes
I live a balanced and purposeful life.
Yes
No
Sometimes
I am getting the results I want from my life and business.
Yes
No
Sometimes
I want to earn how much money in the next 12 months?
I want to earn how much annually 5 years from now?
How many hours per week do you work?
How many hours per week do you want to work?
How many vacation days per year do you take now?
How many vacation days do you want to take every year?
How many hours per week do you spend with the people who are most important to you?
How many hours per week do you want to spend with the people who are most important to you?
How many hours per week do you spend developing yourself to your fullest potential?
If time and money were no issue for you, and you were limited only by your imagination, what would you do?
What skills do you need to develop to be successful personally and professionally?
Why are you a successful candidate for this coaching program?
Do you exercise on a regular basis?
Yes
No
Do you feel you manage your time effectively?
Yes
No
Do you feel you get sufficient rest/sleep?
Yes
No
Do you feel like you have a good handle on your personal finances?
Yes
No
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