Questionnaire Instructions: Please answer the questions below to the best of your ability.

Goal:  To help you reach heightened levels of Clarity, Energy, Courage, Productivity, and Influence
1. Contact Information
2. Occupation
3. Date of Birth
4. Gender
5. Marriage Status
6. Please briefly describe how you heard about me and why you would like a Strategy Session:
General Questions:
Please rate yourself in the following areas of your life on a scale of 1 (lowest) and 10 (highest).
7. Clarity:  Do you feel you are clear about who you are, your purpose, and the direction you want to go in life?
8. Energy:  Do you consistently have enough mental and physical energy needed to excel, accomplish your goals, and feel motivated and happy?
9. Courage:  Do you take action and consistently express who you truly are and what you think, need, and desire with the world?
10. Productivity:  Are you consistently focused and effective, and are you good at minimizing distractions and maintaining priorities?
11. Influence:  Do you feel you have the social influence with your family, friends, and team needed to accomplish your goals?
Please answer the remaining questions the best you can.
12. What do you do for a living? Explain why you choose that career?
13. What are the top three goals you are striving to achieve?
14. What major stressors and challenges are you struggling with?
15. When you feel like your most successful and happy self, what makes you feel that way?
16. What would your dream life look like if you could wave a wand and make it happen?
17. What has prevented you from having that dream?
18. What goal or dream have you ever given up on or failed at, and what do you believe caused you to stop or fail?
19. What three big changes would you like to make in your life in the next twelve months?
20. What are you most proud of and excited about in your life?
21. Why would you like to work with a High Performance Coach?
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