Coaching Questionnaire

Christian coaching is a journey the coach and client will take together. I find it more effective and efficient if you will share some information about yourself before we begin. Please note that this is confidential information and answer only the questions you feel comfortable answering. The more you complete the better acquainted you will be with your coach which in turn will provide the best coaching experience.

Name (Preferred name): (required)

Address:

City, State, Zip:

Phone (Home/Cell):

Phone (Work):

Email:

Personal Website/Blog:

Occupation:

Employer:

Date of Birth:

Marital Status:

Spouse's Name:

Anniversary:

Names & Ages of Children:

What, if any, are your concerns about Christian coaching?

How did you hear about E5 Coaching?

Have you ever been in counseling or therapy?
YesNo

Are you currently?
YesNo

If you answered "yes" to either the previous questions please explain further

Have you accepted Christ as your savior? If so, when?

Why do you want coaching?

In what ways would you like your life to be different one year from now? Be specific.

What's getting in the way of these goals?

List at least three areas in which you procrastinate - the things that you have been avoiding.

Describe your spirituality. What is your relationship with God?

In what ways do you sense God might be challenging you, nudging you in a different direction, or trying to get your attention?

Write a brief life story. (Send an email if you wish.)