Name
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First Name
Last Name
Email
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Occupation
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Phone Number
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What are your top three personal or professional development goals?
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What specific areas do you want to focus on (e.g., leadership, confidence, career growth, relationships, mindset, business development)?
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What challenges or obstacles are currently preventing you from achieving these goals?
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What have you tried in the past to overcome these challenges?
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On a scale of 1-10, how committed are you to making changes in your life? (1 = Not at all, 10 = Fully committed)
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10
9
8
7
6
5
4
3
2
1
Are you open to receiving feedback and implementing new strategies?
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YES
NO
What support systems do you currently have in place (friends, family, mentors, colleagues)?
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Are you willing to invest time and resources (financial, effort, consistency) into your personal development journey?
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YES
NO
Have you worked with a coach before? If yes, what was your experience like?
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What do you expect from a coaching relationship?
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What coaching style or approach works best for you? (Direct guidance, collaborative discussions, self-discovery, accountability check-ins)
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How do you envision success after working with a coach?
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What does personal or professional growth mean to you?
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How will you measure your progress during this coaching journey?
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