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Complete this form and let's start changing your ending.
First and last name
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1. What prompted you to seek coaching at this time?
2. What's the biggest obstacle you're facing right now?
Relationships
Work
Personal habits
Parenting
Other
3. What would you like to accomplish in the next 3-6 months with coaching support?
4. How do you typically cope when you feel stuck or overwhelmed?
Alone
With others
Distractions
Self reflections
Other
5. What personal strengths do you feel you can leverage?
6. Are there past experiences(E.G. childhood, relationships, trauma) shaping your current challenges?
Yes
No
Prefer not to say
7. How self-aware do you feel you are about your emotions and behaviors? 1=Not at all aware 2=Slightly aware 3=Moderately aware 4=Quite aware 5=Very aware
8. On a scale of 1-5 how ready are you to make changes? 1=Not ready 2=Slightly ready 3=Moderately ready 4=Quite ready 5=Very ready
9. How did you hear about Rewriting You Coaching?
Website
Podcast
Word of mouth
Social media
Option 5
Other
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