CLIENT QUESTIONNAIRE
Please complete and return this questionnaire to me prior to our first coaching session. This exercise forms part of your coaching journey and should provide you with valuable insight into who you are and what you want out of life.
1. What are you passionate about?
2. What do you like about yourself? What are your
strengths? {"type":"textarea","name":"__generic2","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
3. What are your challenges?
{"type":"textarea","name":"__generic3","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
4. What
qualities do you look for in a friend?
{"type":"textarea","name":"__generic4","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
5. Who do you most admire? Why?
{"type":"textarea","name":"__generic5","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
6. What are your greatest achievements?
{"type":"textarea","name":"__generic6","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
7. What is your life purpose/mission? If you could do or be anything and knew you couldn’t fail, what would that something be?
{"type":"textarea","name":"__generic7","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
8. What do you do for fun?
{"type":"textarea","name":"__generic8","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
9. What does a typical day in your life look like?
{"type":"textarea","name":"__generic9","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
10. What makes a typical day in your life “a good day”?
{"type":"textarea","name":"__generic10","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
11. What would “the perfect day” for you look like?
{"type":"textarea","name":"__generic11","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
12. If you could have more of one thing, what would that be? Why?
{"type":"textarea","name":"__generic12","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
13. What are you putting up with what is holding you back from the life of your dreams?
{"type":"textarea","name":"__generic13","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"Think about bad habits, beliefs that no longer serve you, recurring problems, unhealthy relationships."}
14. What are your personal life goals?
{"type":"textarea","name":"__generic14","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
15. What are your professional/business goals?
{"type":"textarea","name":"__generic15","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
16. Have you been diagnosed with ADHD? Any other conditions? (ie dyslexia etc)
{"type":"text","name":"__generic16","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
17. Have you received any treatment for your ADHD/other conditions (
ie medication, therapy)?
{"type":"textarea","name":"__generic17","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
18. What do you know about ADHD?
{"type":"textarea","name":"__generic18","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"Think about how it has impacted your life. "}
19. What are you hoping to achieve through ADHD coaching?
20. How will you make sure that you get the most out of our coaching relationship?{"type":"textarea","name":"__generic20","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
21. How would you describe yourself (please choose from the dropdown menu):
StudentParent with ADHDParent of ADHD childSeeking Career Support EntrepreneurEmployed{"type":"select","name":"Tag","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please make a selection for this item.","options":"Student\nParent with ADHD\nParent of ADHD child\nSeeking Career Support\t\nEntrepreneur\nEmployed"}
Any questions?
If you have any questions or comments, including in relation to any of the documents attached, please don’t hesitate to contact me.
Yours sincerely
Your Coach and Advocate
Stephanie Camilleri
