VIP Questionnaire - innertelligence coaching

Your Contact Information

Full Name

First Last

Name you prefer to be called

Email

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Company Name

Job Title and Time in Current Role

Your Personal Favorites

Color

Activity

Type of Food

Reading Genre

Beverage

Author

Snack

Genre of Music

Scent

Musician or Band

Flower

Online Store

Hobbies

Charities /Non-Profits

Your Challenges and Goals

What are 3 changes you would like to make in your life over the next 3 years?

What short-term goals would you like to accomplish over the next 6 months?

How will accomplishing these things positively impact your life?

What previous steps have you already taken to address the changes and the goals you’ve written about here?

What has been the result so far?

Your Challenges and Goals

Where do you see yourself 90 days after your VIP Day?

What do you think it will take to get there?

What have been your most valuable life lessons?

On a scale of 1 to 10, how would you rate your current well-being level with 1 being extreme suffering and / or debilitating illness and 10 being extremely healthy, vibrant, and energetic mind, body and spirit.

How are you currently supporting your overall well-being?

On a scale of 1 to 10, how would you rate your current stress level with 1 being free of stress and feeling very energetic, balanced and at peace body, mind and spirit and 10 being intense long term levels of stress causing extreme physical, mental, or emotional damage.

What is causing you the most stress?

What is the most challenging obstacle you have had to overcome in your life thus far? How did you overcome it?

What are 3 things you are tolerating or putting up with right now in your life personally and professionally?

Your Success Story

What has been the biggest success in your life? How did you achieve it?

What would genuine success look like to you going forward?

What is your best case scenario outcome from your VIP Day?

Your Support System

Who are the most important people in your life, and what is your relationship to them?

Person

Relationship

What do you value most in your life right now?

Have you worked with a coach in the past?

Yes

No

If yes, was it successful? Why or why not?

What type of coaching approaches discourage you or take away your motivations?

Do you engage in any spiritual practices?

Yes

No

Would you like any of them incorporated into your VIP Coaching day?

Are you under the care of a mental health professional, psychologist or psychiatrist?

Yes

No

If yes, what are they treating you for?

Are you on any medications?

Yes

No

Medications

Your Strengths

List your Top 10 CliftonStrengths

Column 1

Column 2

Are there any Strengths that do not currently resonate with you?

Which Strengths most resonate with you?

What activities drain you?

What activities energize you?

What drives you crazy at work?

What do you love about your work?

Your Comments

Describe anything else I should know about you to make your VIP Coaching experience wildly successful.

Name

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