Client Questionnaire

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Client Questionnaire

Client Questionnaire

Love Your Journey, Savor the Destination

Imagine living the life you want as much as you know what you don't want, we want to learn about what you DO want and start pointing your path in that direction

* Indicates required field

How clearly can you envision the life you want to live years from now? *

I know exactly what I want my life to look like I have no idea what my life will look like What I want isn't realistic for someone like me I don't know what tomorrow will look like, much less years from now I take what life gives me and deal with it the best I can Everyone should love their life as much as I do

If you could change one thing, while everything else stays the same, what would that one thing be? *

Even if it seems impossible, if you could change ONE thing (choose your words wisely, be careful what you wish for).

Why does that one thing bother you more than anything else? *

How is your everyday life affected by [that one thing you named above]? *

How have you already tried to change or "fix" this (if you have)? *

Hired coaches and/or consultants I've taken classes or am taking classes now Therapy Self-help (books/courses/videos) I fixed the problem. Until it happened again (got a new job/career, relationship, living situation, friends and had the same problems) I haven't tried anything yet (either scared or it's impossible)

(Select all that apply)

What results have you seen from your efforts? *

I got frustrated and gave up trying to change it. I just deal with it. I lost or wasted a lot of money Lost friends and/or connections Damaged my reputation and/or lost credibility It worked for a while, but then the same thing came up I haven't tried. What I want is impossible. Even if everything else was better, this will always be there.

(Select all that apply)

How will your life be different if/when this problem is resolved? *

How will you celebrate or reward yourself? How do you typically reward yourself? *

What will this enable you to do next or in the future? (What does this stop you from doing now?) What other goals do you have in the meantime (if any)? *

Any other thoughts you'd like to share? *

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