Coaching Initial Assessment Form
Share your goals, current situation, and readiness so your coach can review and arrange your first session.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
*
Email
Phone call
Text/SMS
Other
Best Time to Contact You
*
Age Range
*
Please Select
18–24
25–34
35–44
45–54
55–64
65+
Location / Time Zone
*
Coaching Area of Interest
*
Career
Business
Leadership
Life
Wellness
Relationships
Confidence
Other
If you selected 'Other', please specify your coaching area of interest.
*
What is your main reason for seeking coaching?
*
What are your top three goals you want to achieve through coaching?
*
What are the main challenges or obstacles you are currently facing?
*
What have you already tried to address these challenges?
*
Please rate your current satisfaction in the following areas (1 = not satisfied, 10 = highly satisfied):
*
Rows
Satisfaction (1–10)
Career/Work
Health/Wellness
Relationships
Personal Growth
Confidence
Work-Life Balance
Other
What outcome would you most like to achieve from coaching?
*
Preferred Coaching Format
*
Online
In person
Individual
Group
Preferred Session Frequency and Your Availability
*
Have you previously worked with a coach or therapist? (Optional)
On a scale of 1–10, how ready do you feel to make changes?
*
Not ready
1
2
3
4
5
6
7
8
9
Completely ready
10
1 is Not ready, 10 is Completely ready
Is there anything important your coach should know before your first session?
*
Emergency Contact Details (Optional)
I would like to receive coaching resources and updates (optional).
Yes, please send me resources and updates.
Submit Assessment
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