Life Leadership Coaching
with Doug Kelley, CH, CSL, CFPI
Personal / Professional Life Coaching with a Real-Live Human Being
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Discovery Questionnaire
Preamble Questionnaire
Contact Doug
Please Complete the Form Below and Send BEFORE our First Call Together
(You will also receive a copy via email)
(All fields required unless otherwise noted)
Your Full Name:
Telephone Number + Area Code:
Ext. (Optional):
City, State, Country of Residence:
E-Mail Address:
Best Time for Coaching Calls:
Please SELECT Best Time for Coaching Calls Morning Afternoon Evening Anytime To Be Determined
Type of Coaching Desired:
Tele-Coaching
In-Person Coaching / Hypnosis
About You
1.
3. What do you love most about your life?
4. Where do you want your life to be 1 year from now?
5. If you accomplished one major goal in the next 3 months, what would it be?
6. What is the biggest concern you have right now?
11. In what area(s) would you like to grow and experience positive change within yourself?
12. On a scale between 1 (lowest) and 10 (highest), where would you rate your self-esteem? Select 1 2 3 4 5 6 7 8 9 10
About Your Blocks
13
15. What fears do you have concerning moving forward with your objective(s)?
Regarding Coaching
16. What are you expecting to happen now that you have a coach?
17. What do you want our coaching to focus on primarily (at least initially)?
18. What is the most empowering and helpful thing I can do for you during our sessions?
19. How will you know you are getting MORE in return than your investment of time, money and energy from our coaching? What will be happening in your life?
20. When your coaching is complete, what will you like to say I helped you with the most?
You will receive a copy of your completed form via email.
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