Goal Setting Questionnaire
Reflect on your goals, motivations, and action plans to achieve success.
Full Name
*
First Name
Last Name
Which area of your life does this goal relate to?
*
Please Select
Career
Education
Health & Fitness
Personal Development
Relationships
Finance
Other
State your main goal clearly and specifically.
*
How important is this goal to you?
*
Not important
1
2
3
4
5
6
7
8
9
Extremely important
10
1 is Not important, 10 is Extremely important
How motivated are you to achieve this goal?
*
1
2
3
4
5
What is your target completion date for this goal?
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
What is your current status regarding this goal?
*
Just starting
Making progress
Facing obstacles
Nearly achieved
Other
Identify possible obstacles you might face in achieving this goal.
What resources or support will help you achieve your goal?
Mentorship/Coaching
Family/Friends
Online Courses/Workshops
Financial Support
Accountability Partner
Other
Please outline the main action steps you will take to achieve your goal.
Rate your confidence in achieving this goal.
*
Not confident
1
2
3
4
5
6
7
8
9
Very confident
10
1 is Not confident, 10 is Very confident
How will you track your progress? (Select all that apply)
Daily journal
Weekly check-ins
Progress chart/graph
Accountability partner
Other
How committed are you to taking consistent action toward your goal?
*
1
2
3
4
5
Submit
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