PRE - COACHING QUESTIONNAIRE
I’m so excited that you chose coaching on your health journey. I would love the opportunity to get to know you better and for you to tell me openly and honestly about what you would most like to achieve from working with me as your coach.
With an open mind and heart,
Email Address *
1. What are your top 3 health and wellness goals? Try to be SMART with your goals, ie. Specific, Measurable, Achievable, Realistic and Timely
2. What would you like to get out of coaching? Don’t be afraid to say the big goal or goals you are secretly hoping to happen.
3. How would you love to feel in three months time? Dig in deep here - it may be something we can work on together. You want to feel....?
4. What feels really good about your life right now? What challenges are you having in regards to your health?
5. What is your self-talk like? Do you tend to be kind to yourself or do you tend to be more negative?
6. What are your beliefs about your ability to transform your health?
7. What are your relationships with family and friends like? Eg. do you feel that they are supportive and caring or unsupportive and causing you stress?
8. What practices do you routinely do to connect to your inner self? Do you feel you are being your true self most of the time?
9. How much time, on average per day, do you spend in the sun and in nature? When you are in the sun, do you use any sun protection? How much artificial lights do you use after the sun goes down (eg, technology; house lighting)?
10. How much time do you spend on using wifi devices? Please also list the devices.
11. How often are you physically active, on average, per week? By physically active I mean you are continuously moving your body for 15 minutes or more.
12. How well are you sleeping? Eg, how many hours per night on average, how do you feel upon wakeup?
13. On a scale from 1-10, how would you rate your current stress level? (1-being not stress at all, 10-being very high level of stress/anxiety)
14. What is your predominant type of food intake (eg home cooked, store bought, mainly meat, vegetarian)? What do you generally eat and drink on a typical day
15. On a scale from 1-10 (1- being not at all, 10 - being absolutely out of this world)
a. How well are you at doing what you say you will do?
b. How ready are you to commit to make change?
16. Is there anything else you really want to tell me? For example, a question or area you hope I won’t ask you about, but secretly, you want me to?
How did you hear about Alison and alisondaviswelness.com?