PRIVATE COACHING PRE-WORK

This questionnaire will serve as an opportunity for Kelly Eide to get to know you and your present life situation better with the goal of making your coaching experience as effective and meaningful as it can possibly be. It's also a great opportunity to you to be intentional about why you are choosing to engage in a Coaching relationship.

Please read the following questions carefully and answer them as honestly as possible. Your responses will always be kept strictly confidential.

NAME

First Name

Last Name

PHONE NUMBER

Country

(###)

###

####

YOUR SKYPE ID

If Skype is not a viable tool in your country then I suggest Zoom Meeting or All App as an alternative communication tool.

YOUR PREFERRED DAY OF THE WEEK & PREFERRED TIMING FOR SESSIONS

I will use this feedback to give you some options for scheduling our first conversation. Please be as specific (Tuesday at 12 noon) or as general (any weekday morning before 9am) as you are able and we will find a mutually convenient time.

WHAT INSPIRED YOUR DECISION TO EXPLORE COACHING?

WHAT WOULD BE THE BEST POSSIBLE OUTCOME FROM YOUR COACHING EXPERIENCE?

PERSONAL INFORMATION

These questions are intended to elicit the most important things your coach should know about you right now. Please share whatever you feel comfortable expressing about the following. If your session is in a group, your answers will always remain confidential, even during your session which means that if you do not introduce the subject, I will not either:

YOUR CHILDHOOD OR UPBRINGING: HOW DO YOU CURRENTLY FEEL ABOUT IT? WHAT WAS/IS YOUR RELATIONSHIP WITH EACH OF YOUR PARENTS/CARETAKERS LIKE?

YOUR INTERESTS/ HOBBIES AS A CHILD: WHAT WERE THEY? WHAT INTERESTS/ HOBBIES DO YOU CURRENTLY HAVE?

IF YOU ARE CURRENTLY IN AN INTIMATE RELATIONSHIP (DATING, MARRIED, DIVORCED, ETC.) PLEASE DESCRIBE THIS RELATIONSHIP AND HOW YOU FEEL ABOUT IT, FROM YOUR PERSPECTIVE. IF YOU ARE CURRENTLY SINGLE PLEASE DESCRIBE HOW YOU FEEL ABOUT IT.

IF YOU ARE YOU CURRENTLY EMPLOYED? PLEASE DESCRIBE YOUR CURRENT SITUATION AND HOW YOU FEEL ABOUT IT, FROM YOUR PERSPECTIVE.

PLEASE LIST UP TO 3 EVENTS/RELATIONSHIPS/EXPERIENCES IN YOUR PRESENT LIFE THAT YOU ARE ENJOYING.

PLEASE LIST UP TO 3 EVENTS/RELATIONSHIPS/EXPERIENCES IN YOUR PRESENT LIFE THAT YOU FEEL ARE STRESSFUL OR THAT YOU FEEL YOU ARE STRUGGLING WITH.

DISCLOSURE OF CONCURRENT TREATMENT

ARE YOU CURRENTLY IN TREATMENT OR CONSULTING WITH ANY BEHAVIORAL HEALTH OR MEDICAL TREATMENT PROFESSIONAL? ARE YOU TAKING ANY MEDICATION?

DO YOU HAVE ANY QUESTIONS OR CONCERNS SURROUNDING COACHING?

IS THERE ANYTHING FURTHER YOU WOULD LIKE US TO KNOW THAT YOU THINK IS RELEVANT?

I look forward to exploring a Coaching relationship with you.

Thank your for your trust and courage.

Speak soon,

Kelly