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APPLICATION: GPS 360 FREE CONSULTATION
15
Questions
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1
Which of these images do you feel best represents where you are right now?
I Know I Need a Change. But, I Don't Know Where to Start.
I Know Where I Want to be. But, I Don't Know How to Get There.
My Destination. I'm in the Car. But, I'm Stuck.
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2
WORK AND CAREER: Which of these things are a challenge in your work or career life?
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Choose as many as apply.
My work is encroaching on my personal or family life.
I have way too many distractions during the day. It's pulling me off focus.
I'm loosing sleep because of work.
I'm getting calls, emails, and/or texts while on vacation. I can never really relax.
Office politics or intra-office conflicts are taking too much of my time.
I'm over stressed.
I'm overwhelmed.
I'm feeling isolated.
My personal life is a wreck and I'm fed up!
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3
PERSONAL & FAMILY LIFE:
Which of these are a challenge in your personal life?
Choose as all that apply.
I have no time for a personal life.
Work is causing tension in the home.
I take work home in the evenings and weekends.
I miss a lot of family gatherings and events.
I wish I had more time for the kids.
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4
CAREER DIRECTION: Are you satisfied with your current job or career?
It may be time for a change
I feel like something is missing.
I'm not fulfilled in my current position.
I want a change. But I'm not sure how to go about making that change.
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5
Is there anything else you'd like Coach Linda to know about your situation?
Your responses are kept in confidence.
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6
I can make personal decisions for my life.
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Choose One.
True
False
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7
I understand that accepting feedback will enable me to improve, and I cannot be overly sensitive to criticism.
YES
NO
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8
I believe that my past does not have to equal my future.
YES
NO
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9
I am ready to discover hidden mindsets that are holding me back.
YES
NO
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10
I am willing to try new things and go outside of my comfort zone.
YES
NO
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11
I want to change my life and I am ready to engaging in the process to make change.
YES
NO
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12
I am ready to commit time, energy and resources to accomplish my goals.
YES
NO
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13
Name
First Name
Last Name
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14
E-mail
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15
Math Challenge
Answer the math question below.
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