This intake form is meant to be a benchmark as to how you think, and what your readiness to coaching is. It will also gather important information to help us assist you in the process in the most efficient way.

Name(Required)

General Introspection About Coaching

Coaching is always about transformation. Are you committed to changing?
Can you allow a coach to enter into accountable relationships in a way that hold you to your commitments to change?
Have you been successful changing yourself in the past?

Time For Some Ratings

Read each statement below, and grade that particular statement on a scale from 1 to 5, with 1 being ‘No Way!’ and 5 being ‘Oh, Yeah!’

1. 2.3. 4. 5.
1. I know my strengths
2. I am aware of things I must change
3. Others are aware of things I must change
4. I am firm in the decisions I make (no second guessing)
5. I am confident in the decisions I make (no wrong answers)
6. I am faithful in the decisions I make (I follow through)
7. I am empathetic in the decisions I make (aware of how they affect others)
8. I will be different one year from now
9. I am honest with myself
10. I know that coaching is worth the money I am paying, and is more valuable than the free advice I get from friends and family
1. 2.3. 4. 5.
1. I know how my business is differentiated
2. I know the way forward in my business
3. I know how to change my business to become more valuable
4. My value is properly reflected by my price
5. I will be more valuable 2 years from now
6. I will be a better leader 2 years from now
7. I am assessing our business value continually
8. I am continually becoming a better leader
9. Our decisions prove to be right

Some Final Questions for Introspection