Client Questionnaire

Welcome

Thank you for choosing to work with me. This reflective questionnaire helps me get to know you and tailor our coaching sessions to best support your needs, goals, and preferences.

You're invited to answer as fully as you're comfortable. Your responses are securely emailed to Priscilla only. They are not stored on this website or by any third-party service. A copy will be forwarded to you manually so you have a personal record.

Client Questionnaire

Personal Details

Full Name: Preferred Name: Employer / Job Function: Education / Field of Study: Gender Identity: Age Group (e.g. early 30s): Relationship Status: Children:

Goals

Top 5 Goals (next 1–2 years): Top 5 Challenges:

Your Coaching Preferences

Main objectives for coaching: What helps you when you're stuck? How would you like me to be as your coach? Beliefs that would support coaching impact: Any expectations for coaching? Anything else I should know?

At a Deeper Level

What currently occupies your time professionally? Skills or knowledge you're developing? How does your work contribute to personal goals? Professional changes you’d like to make: Personal changes you’d like to make: Your learning style: How are you best motivated? How do you respond to challenges? What are your most important values? Are you living congruently with them? Anything else to share?

Current Life Satisfaction (1 = Not at all satisfied, 10 = Extremely satisfied)

Work / Career: 5

Relationships: 5

Health & Wellbeing: 5

Sense of Purpose: 5

Work-Life Balance: 5