Client Intake Form | SharShar TV

Date

Month

Day

Year

First name

Last name

Birthday

Month

Day

Year

Phone

How did you hear about my services?

Emergency Contact: (Name, Phone Number, Relationship):

Think back to when you initially reached out to me, how did /do you envision working with a life coach ?

What areas are most important for your focus personal or work?

What challenges or issues do you believe should be your focus and why?

What are three obstacles keeping you from achieving your goals?

How do you define success? And how do you measure this?

Where do you see yourself after our coaching relationship ends?

What are your main motivations when you think about your goals?

What challenges are you currently facing that hinder you from achieving your goals?

In the past, how have you dealt with difficult events or situations?

How can I most effectively support you on your journey?

How do you imagine the coaching relationship between us?

On a scale of “very committed” to “not very committed,” how committed are you to achieving your goals?

What do you value most?

On a scale of 1-10 how do you rate the quality of your life?

How would you describe your life as a whole?

What makes you happy?

What is your biggest pet peeve?

What do you consider your life’s biggest success so far? How did you accomplish this?

When you face an obstacle, how do you handle it?

How would you describe a successful coach/client relationship?

Welcome to Shar Shar TV