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L E A R I M P A C T
Consulting Group, Inc. Joel M. Rothaizer, Ph.D. CEO
Sandra L. Hill,
M.A., President
Coaching Intake Packet Please Tell Me About You Please take the time to answer the following questions prior to our first coaching session and return them by e-mail, fax, or snail mail. Please answer them as honestly as possible. This information will save us time, and will help us to focus our work together. All of your responses are confidential to the fullest extent allowable by law. List your three most important goals for coaching 1)
2)
3)
List up to seven other goals that are important to you 1)
2)
3)
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7) What is the single most important result you want to accomplish?
What is the cost of not accomplishing this result? Please consider the
cost to you (both personally and professionally), to those close to you,
and, as appropriate, to your team, your customers, your organization, and
beyond.
What would be the benefit of accomplishing this result? Please consider
the benefit to you (both personally and professionally), to those close
to you, and, as appropriate, to your team, your customers, and beyond.
How high a priority is this result for you at this time? Is it something
you’d LIKE to do, something you SHOULD do, something you feel COMPELLED
to do, etc?
What are the 10 most important things for me to know about you? 1)
2)
3)
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5)
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7)
8)
9)
10)
Personal and Professional Vision
Do you have a personal vision for your life? If so, what is it?
Do you have a professional vision for your work life? If so, what is
it?
Strengths and Challenges What are your personal and professional strengths? 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) What are your current external challenges? What are you dealing with right now that needs immediate attention or resolution? 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) What are your inner challenges, blind spots, areas most in need of development? What is it about you that stops you or makes it difficult for you to achieve or exceed your goals? 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) What are your personal values? What is most important to you? 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) What “self-care” activities do you do on a regular basis that keep you physically, mentally, emotionally, and spiritually balanced? 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) What would help you become more physically, mentally, emotionally, and spiritually balanced?? 1) 2) 3) 4) 5) 6) 7) 8) 9) 10)
Coaching is about moving forward from the present. At the same time,
our history plays a major role in shaping who we are, both in defining
our strengths and in creating patterns that can tend to get in our way.
Is there anything you’d like to share about your past that still impacts
you, and that would be useful for me to know as your Coach?
1) Where do you get your energy?
2) What (if anything) drains your energy? What consumes your time that
doesn’t serve you or your vision?
3) In what ways do you honor yourself and your core values?
4) In what ways (if any) do you not honor yourself and your core values?
5) If you knew you couldn’t fail, what would you most like to do?
6) What do you notice about people who excel at what they do? What distinguishes
them from their peers?
7) What do you notice about people who don’t achieve what they are capable
of?
8) What are you most proud of?
9) What (if anything) do you most regret not doing?
10) What was the best advice you’ve ever been given? Why?
Organizational Context (Skip this section if you are not currently working within an organization) Describe the organizational culture in which you’re currently working,
including its strengths, challenges, and values. What do you most appreciate
about it? What would you most like to change about it?
Different people like to be coached in different ways. Please identify
your preferences.
A Great Coaching Session: What would a great coaching session look like
to you? What are you most looking for during our times together?
Structure: Do you like sessions to be highly structured or less structured?
Is it important for you to have a sense of linear progress toward a clear
goal, or are you sometimes content with a more free flow of ideas?
Pace: Do you prefer a slow, moderate or fast pace? Or no predetermined
pace?
Focus of Coaching: Do you want our focus to be business only? Professional
development? Professional and personal? Only personal?
What Else Would You Like From Me As Your Coach? What Are You Expectations
Of Me?
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Personal Coaching | Relationship Coaching | Enneagram Coaching/Consulting Contextual Coaching | Mission & Vision | Organizational Energy Audit | Contact Us Directly e-mail
partners@clear-impact.com
Clear Impact Consulting Group, Inc.
"Assisting individuals and organizations
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