Communication Confidence Coaching Intake Questionnaire
Please complete this questionnaire to help us understand your communication goals, challenges, and coaching needs.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Method of Contact
*
Email
Phone Call
Text Message
Video Call (Zoom, Teams, etc.)
How confident do you feel in your communication skills in the following situations?
*
Rows
Not Confident
Somewhat Confident
Confident
Very Confident
One-on-one conversations
1
2
3
4
Group discussions
5
6
7
8
Public speaking
9
10
11
12
Virtual meetings
13
14
15
16
Written communication (emails, reports)
17
18
19
20
What are your main goals for communication confidence coaching?
*
Improve public speaking
Increase assertiveness
Reduce anxiety in social situations
Enhance workplace communication
Develop active listening skills
Other
Please describe any specific communication challenges you are currently experiencing.
*
On a scale of 1 to 10, how would you rate your current overall communication confidence?
*
Not confident at all
1
2
3
4
5
6
7
8
9
Extremely confident
10
1 is Not confident at all, 10 is Extremely confident
Have you worked with a coach or attended communication workshops before?
*
Yes
No
If yes, what did you find most helpful or unhelpful in your previous coaching or workshops?
What is your preferred availability for coaching sessions? (Select all that apply)
*
Weekday mornings
Weekday afternoons
Weekday evenings
Weekends
Is there anything else you would like your coach to know before your first session?
Submit
Should be Empty: