Client Information
Client Questionnaire
The following questions will help us design our coaching alliance together. Their intention is twofold: 1. To stimulate thought and provoke inquiry into your life, and; 2. To help me get a sense of how you view yourself and the world (since everyone has a unique way of viewing the world!) Take the time you need to both review the questions and chew on the answers. Remember that there are no right or wrong answers. It’s just the beginning of a process. I have provided you with a word document, so you may add you answer below each question, using as much space as you need.

How satisfied are you with your whole life?

Which areas contribute to your satisfaction? Which detract?

How does it all balance?


10 Completely satisfied. You couldn’t be more satisfied with where you are at this point in your life. You are right on track.

5 Middle of the road. It’s OK, but there are many changes that you could make here.

0 Completely Unsatisfied. You’d be much happier if everything about this category was completely different.

Values represent who you are and what you hold to be important in your life. They are not universal morals, or standards of good and evil. They are not things that come and go, or principles that you develop over time. Your values are inherent to who you are.

During our work together, we will often look at your values. In the beginning of our work together it is often useful to clarify your top values.

Spend some time working on the exercises on this page. They are intended to increase awareness for both of us around your values. We will do exercises during the discovery session that build on your work on this page.

Think of three peak times in your life, times of extreme pleasure or adventure, learning or satisfaction, peace or well-being. Describe these times below, with as many pertinent details as possible.

What was it about these moments or experiences that made them so wonderful? What aspects of these peak times would you like to see in your life today?
What special qualities do you remember about these times, qualities towards which you would work to have more in your present and future life?

A goal is a specific measurable result (e.g. increase income 30% by July 1; enter graduate school by September 2017). It is important to remember when working with goals that the goal itself is just a landmark or signpost to use as you move forward in life. Goals are a way of measuring progress and evaluating the effectiveness of your actions.

If you do not reach your goal by your “by when” time, it is an opportunity to look and see:
• If you are truly committed to that goal (It’s fine if you are not. It was your goal in the first place), and
• If the actions that you have been taking are appropriate. (There’s no point in continuing to drive East if you are in Salmon Arm and want to get to Vancouver)

It is also important to set goals that are compelling and will help you stretch and grow. These goals need to be more than just a glorified “to do” list. I encourage you to set exciting, challenging goals and to welcome the occasional failure that inevitably accompanies this kind of courageous striving.

Your goals may come to you quickly or you may need some inspiration. We will continue to add to and modify this list during our coaching progress.

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