Executive & Leadership Unlimited Coaching - Elisha D'Agostino Empowerment Coach

Name: *
Email: *
Cell Phone: *
Street Address: *
City: *
Province: *
Postal Code: *
Time Zone:

COACHING TAKE OFF QUESTIONS

 

Hi client,

 

So that we can get started right away and make the most of your booked coaching sessions please complete the following statements from an authentic place and email it back when you feel comfortable with your answers prior to your coaching session. There are no wrong answers and they will be kept confidential and destroyed after our last coaching session. 

 

If you have any questions, please feel free to contact me.

 

 

PART I:

 

 

My greatest strengths, gifts or talents are …

 

{"type":"text","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic2","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic3","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

My greatest development opportunity is …

 

{"type":"text","name":"__generic4","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic6","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}


{"type":"text","name":"__generic5","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}


 

What I want more of in my life is …

 

{"type":"text","name":"__generic7","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic8","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic9","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}


 

What I want less of in my life is …

 

{"type":"text","name":"__generic10","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic11","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic12","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

I am motivated or inspired by…

 

{"type":"text","name":"__generic13","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 {"type":"text","name":"__generic14","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic15","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}


 

What holds me back the most is…

 

{"type":"text","name":"__generic16","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic17","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic18","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

What is consuming my time and energy and is not serving me is…

 

{"type":"text","name":"__generic19","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic20","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic21","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

The people most important to me are …

 

{"type":"text","name":"__generic22","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic23","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic24","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

What ACHIEVEMENTS are you most proud of? (It's not about size, but whether it felt like an achievement to you).

 

{"type":"text","name":"__generic25","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic26","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic27","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

My friends would describe me as …

 

{"type":"text","name":"__generic28","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic29","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic30","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

The people I work with would describe me as …

 

{"type":"text","name":"__generic31","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic32","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic33","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

My 5 most important values are …

 

{"type":"text","name":"__generic34","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic35","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic36","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic37","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic38","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

My basic spiritual (or philosophical) belief is … 

 

{"type":"text","name":"__generic39","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic40","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic41","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

A more balanced life for me would involve …

 

{"type":"text","name":"__generic42","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic43","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic44","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

What I enjoy doing most is …

 

{"type":"text","name":"__generic45","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic46","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic47","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

The most important thing in life for me is …  

 

{"type":"text","name":"__generic48","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

What I am currently dealing with that I would like to address is …

 

{"type":"text","name":"__generic49","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic50","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic51","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic52","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

What I am currently trying to create is …

 

{"type":"text","name":"__generic53","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic54","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic55","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic56","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

Two steps that I could take immediately that would make the greatest difference in my current situation are … (If unknown leave blank)

 

{"type":"text","name":"__generic57","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic58","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

What I most want from my coach is …

 

{"type":"text","name":"__generic59","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

You can best coach me by … (Being firm, being subtle, letting me wander around until I see the obvious)

 

{"type":"text","name":"__generic60","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

What you can say to me when I am most stuck that will return me to action is …

{"type":"text","name":"__generic61","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}


 

 

Things I do on a regular basis to keep me physically, mentally, emotionally and spirituality balance…

 

{"type":"text","name":"__generic62","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic63","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic64","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

I will know our coaching is successful if/when …

 

{"type":"text","name":"__generic65","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

What I want to accomplish in my life in order to feel fulfilled is …

 

{"type":"text","name":"__generic66","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic67","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic68","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

If you are aware of your life purpose, please describe it …

 

{"type":"text","name":"__generic69","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic70","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic71","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

List 5 goals you want to achieve over the next 2 years…

 

{"type":"text","name":"__generic72","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic73","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic74","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic75","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic76","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

Things I want you to know about my family are …

 

{"type":"text","name":"__generic77","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic78","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic79","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

I get a feeling of enough and inner peace right (Before, During or After) …

 

{"type":"text","name":"__generic80","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic81","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic82","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

I believe I need _______ to be safe…

 

{"type":"text","name":"__generic83","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic84","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic85","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

I believe I need _______ to be Okay…

 

{"type":"text","name":"__generic86","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic87","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic88","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

I believe I need _______ to be Valued…

 

{"type":"text","name":"__generic89","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic90","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

{"type":"text","name":"__generic91","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

PART II: Designing the Coaching Relationship:

 

Coaching is a partnership between a coach and client whose main purpose is your success and wellbeing. A coach’s role is to bring out your best and to provide ongoing support for your personal and professional growth and achievement. Coaching often involves gaining insight into what is most important to you in terms of lifestyle, values and goals to develop a personalized plan of action to make your aspirations and dreams a reality.

 

 

A.        How do you want me to be as your coach?

 {"type":"text","name":"__generic92","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

    


B. 
      How would you like me to support you as your coach? 

 

{"type":"text","name":"__generic93","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

What does support look like to you?

 {"type":"text","name":"__generic94","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

C.        How do you want to be held accountable?

 {"type":"text","name":"__generic95","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

D.        I’d like to share with you what my expectations are as your coach:

 

 

·         Being on time for the call or meeting.

 

·         Deep commitment to your own personal growth and goals.

 

·         Carrying out assignments that you give yourself or requests that I make of you.

 

 

 

Your comments please: {"type":"text","name":"__generic96","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}

 

 

 

 

 

Almost done! Please continue on to PayPal to complete your purchase.

You will be billed $10,459.00.