Coaching Questionnaire

Answering the following questions will allow your coach to support you as an individual. It will also give you more time with the coach discussing your situation rather than answering these
questions during the session.

Name *


Phone *




Email *

Are you in a relationship?

If “no” skip next 3 questions.
Significant Other’s Name

Significant Other’s Age

How long have you been together?

Do you have kids? What are their ages?

What are the top 2-3 problems / areas of concern in your relationship?
Why did you decide to seek coaching?

What made you interested in having a coach?

What are your specific goals with this coaching call?

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