Q1. Your Details

Name of Person:

Location based

Date of Birth

Occupation:

Annual Remuneration:

Contact Number:

Email:

Q2 Goals

Please state your 3 most important (tangible) goals for

(a) The next 12 Months

(b) The next 3 months

Q 3. Obstacles

What obstacles are you struggling with at the moment that may prevent you achieving your goals?

Name 3 current challenges

1. 

2. 

3.

Q4. Improvements

What do you think you need to do to double your (a) personal happiness and (b) business/job over the next 12 months

List the 3 things you need to do to improve your (a) personal happiness

1.

2.

3.

List the 3 things you need to improve your (b) business/job

1.

2.

3.

Q5. Strategies Used

What Strategies have you already tried to improve your business (and life) that worked and didn't work

Strategies that Worked

1.

2.

3.

Strategies that did not work

1.

2.

3.

Q6. Restraints

What do you think holds you back the most

Restraints

1.

2.

3.

Q7. Working with a Coach

Have you worked with a Coach previously?

1. If yes, what were your experiences?

2. What objections would you have to working with a Coach in the future?

Q8. Your own business

If you were given the opportunity today to start up your own business with little of no capital; -

(1) What would be the biggest benefit to you that would enable you decide to make an immediate start?

And..

(2) What is the biggest restraint that would stop you making an immediate start?

Q9  Do you have the Time, Energy and Financial resources s to make a premium level investment into yourself and coaching right now?

Yes or No