Life Leadership Coaching

with Doug Kelley, CH, CSL, CFPI

Personal / Professional Life Coaching with a Real-Live Human Being

 

 

 

Discovery Questionnaire

 

 

 

 

 

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: 

 

Type of Coaching Desired: 

 

  Tele-Coaching

  In-Person Coaching / Hypnosis

 

About You

 

1. Please list 3 things you like best about you.

 

 

2. What are you most passionate about?

 

 

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?

 

 

7. What is the biggest opportunity that you're not taking full advantage of?

 

 

8. What have you not started yet because you're not sure how to make it happen?

 

 

9. What situation requires your immediate focus?

 

 

10. What are your top 3 priorities 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?  

 

 

About Your Blocks

 

13. What do you believe is holding you back or blocking you?

 



14. What is the most critical thing you say to yourself?

 



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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