How would you describe your overall outlook on life?
Optimistic
Realistic
Skeptical
Uncertain

Do you believe success is more dependent on:
Hard work and effort
Mindset and belief systems
External factors
A combination of all the above

How do you typically approach problems or obstacles?
Find solutions and take action
Analyze before decision
Procrastinate or feel stuck
Avoid until necessary

How do you view yourself?
Spiritual Approach
Intuitive Approach
Open to both

What are your core values? (Check up to 3)
Integrity
Growth & Learning
Freedom & Independence
Financial Success
Relationships & Connection
Spirituality & Faith
Legacy & Impact

Do you believe your thoughts and beliefs influence your results?
Absolutely, mindset is everything
Somewhat, but actions matter more
Not really, external circumstances are the main driver

What are your top 3 goals right now?

What is your biggest challenge in achieving these goals?
Lack of time
Lack of clarity
Lack of motivation or discipline
Fear of failure or self-doubt
Financial or external limitations

What is the #1 thing, if solved, that would make the biggest impact on your life/business right now?

Have you ever worked with a coach before? If so, what worked and what didn’t?

How confident are you in your ability to achieve your goals?
1–3 (Not confident at all)
4–6 (Somewhat confident)
7–8 (Fairly confident)
9–10 (Very confident)

How do you handle stress and setbacks?
Push through and keep going
Take a step back and re-evaluate
Get discouraged and lose momentum
Avoid dealing with it altogether

How committed are you to making real changes in your life right now?
Just exploring
Want change, unsure where to start
Ready but need guidance
Fully committed

What is one belief about yourself that you would like to change?

If we work together, what would a successful outcome look like for you?