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Performance Coaching Onboarding Questionnaire

Please fill out this questionnaire before scheduling your first session. You will receive an email with your completed survey for your own records.

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Basic Information

Just some basic info to get us started. :)

Question 2 of 44

Full Name

Question 3 of 44

Preferred Email Address

Question 4 of 44

Best Phone Number to reach you?

Question 5 of 44

What is your mailing address (so we can send you something nice!)?

Question 6 of 44

What is your date of birth (MONTH/DAY)?

Life Ratings

For the following areas of life, please rate your current level of satisfaction  (10 = completely satisfied, 0 = completely unsatisfied)

Question 8 of 44

Hobbies / Leisure / Play

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 9 of 44

Career (being a sought after expert or resource)

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 10 of 44

Job (the work you do with your mind and body on a daily basis)

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 11 of 44

Income (the monthly or annual income you generate)

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 12 of 44

Wealth (building long term wealth and financial stability)

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 13 of 44

Legacy (contributing to humanity or your community)

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 14 of 44

Sex

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

New Choice

M

I'd rather not say

Question 15 of 44

Intimacy & Romance

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 16 of 44

Relationship with significant other / desire to have a relationship

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 17 of 44

Parenthood / Desire to become a parent

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 18 of 44

Relationship with mother

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 19 of 44

Relationship with father

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 20 of 44

Relationship with siblings

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

N/A

M

I'd rather not say

Question 21 of 44

Relationship with close friends

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 22 of 44

Health and Well Being

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 23 of 44

Physical Fitness

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 24 of 44

Peace of Mind

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 25 of 44

Spirituality and Faith

A

10

B

9

C

8

D

7

E

6

F

5

G

4

H

3

I

2

J

1

K

0

L

I'd rather not say

Question 26 of 44

Please enter any ratings for areas of life not covered (optional). If none, type "None."

Goals & Objectives

In this section please provide information about your goals and objectives.

Question 28 of 44

Please describe your medium term (1 - 3 year) goals for your life and your business/career.

Question 29 of 44

What concerns, obstacles, or challenges do you think you will face in achieving your medium term goals?

Question 30 of 44

If you could accomplish ONE specific result from our coaching, what would it be and why? (Please be as specific as possible)

About Your Business

The following questions help me understand your current business or employment.

Question 32 of 44

Which statement best applies to your work and business situation?

A

I work full-time for a company but I want to start my own business.

B

I work part-time in my own business but I also have a full-time job.

C

I operate a "soloprenuer" business which employs myself.

D

I own and operate a small business with 3 to 100 employees

E

I am a business partner/investor in a business with more than 100 employees.

F

I'm currently in transition in my work and income.

Question 33 of 44

What is your approximate annual business revenue (before taxes)?

A

$1,000 to $12,000 per year.

B

$12,001 to $24,000 per year

C

$24,001 to $48,000 per year

D

$48,001 to $96,000 per year

E

$96,001 to $252,000 per year

F

$252,001 to $750,000 per year

G

$750,001 to $1.5 million per year

H

$1.5 million to $3.0 million per year

I

$3 million dollars per year or more

J

I don't know

Question 34 of 44

Please describe your product or services. What type of customers do you serve? Why do they hire you?

Question 35 of 44

How do you generate new business opportunities or clients? What are your current "lead sources?"

Question 36 of 44

Which of the following technology systems do you use in your business? (Select all that apply)

(Select all that apply)
A

Email Marketing System (e.g. Mailchimp, ConstantContact, etc.)

B

Customer Relationship Management (CRM) System (e.g. Salesforce, Zoho)

C

Accounting System (e.g. Quickbooks, Quicken)

D

Website Platform (Squarespace, Wordpress, etc.)

E

Industry specific software

Question 37 of 44

Please provide any other details about your business you think I should know.

Inner Awareness & Coaching

In the next section, please answer the questions related to inner awareness and coaching styles.

Question 39 of 44

What is one thing you do not like doing that you know is good for you, your business, or your relationships?

Question 40 of 44

What is something you love doing that you wish you could do more of?

Question 41 of 44

When you get confronted or scared, how do you get people to "back off"? What would people see you doing or not doing in response to confrontation or fear?

Question 42 of 44

What are your "trigger topics"? What are your hot button issues? What do you find yourself getting most upset about?

Question 43 of 44

Have you ever hired a business or life coach before?

A

Yes

B

No

Question 44 of 44

Are you willing to be coachable? Coachable requires giving up your point of view or beliefs.

A

Yes

B

No

C

I'm not sure.

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