Client intake questionnaire

As your coach, it’s important for me to understand your unique lens on life—how you see the world, yourself, your purpose, and the path ahead. The questions below are designed to spark meaningful self-reflection and help us build a powerful foundation for our work together.

There are no “right” or “wrong” answers—only honest ones that reflect who you truly are. You can respond in 1–3 lines per question, or use bullet points, metaphors, or short paragraphs—whatever feels most natural to you.

You’re welcome to take a couple of days to complete this. We may or may not explore every answer during our first session, but your thoughtful responses will guide our journey. These questions are for you as much as they are for me.

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What is currently missing in your life, that if it were present, would create more meaning, peace, or joy?

How do you best receive support, encouragement, or challenge from others? What should I know about how to work with you most effectively as your coach?

Imagine it’s five years from now. You’ve achieved one major, meaningful goal—with coaching by your side. What was the goal, and what difference did having a coach make?

Do you believe in a higher power, universal force, divine intelligence, or spiritual energy? If so, how does it shape your values, decisions, or perspective?

Do you have a stillness, meditation, or mindfulness practice? If so, describe it briefly. What role does nature, silence, or solitude play in your personal well-being?

What do you feel is your life’s purpose—or the deeper reason you are here? How does this purpose show up (or not show up) in your daily life?

What fears, beliefs, or recurring patterns do you suspect hold you back the most?

What strengths or qualities do others often reflect back to you? Which ones do you personally acknowledge as your gifts?

Coaching Agreement & Waiver

Client Coaching Agreement & Acknowledgement – Understanding & Consent

First Name

Last Name

Phone

Address

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone Number

Referred/Recommended by

Date

Client Name

I confirm that I have read, understood, and agree to the coaching agreement above.

Client intake questionnaire

Coaching Agreement & Waiver

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