Welcome! Thank you for considering [Your Coaching Business Name] for your personal development journey. This form will help us understand your needs and goals, and ensure we can provide you with the most effective coaching experience. Please answer all questions thoughtfully and honestly.
First Name
Last Name
Preferred Name
Date of Birth
Email Address
Phone Number
Mailing Address
City
State/Province
Postal/Zip Code
Occupation/Industry
How did you hear about [Your Coaching Business Name]?
What are your primary reasons for seeking personal development coaching?
What specific areas of your life would you like to improve? (Check all that apply)
Career Development
Relationships (Personal/Professional)
Communication Skills
Confidence/Self-Esteem
Stress Management/Well-being
Time Management/Productivity
Goal Setting/Achievement
Life Purpose/Meaning
Leadership Skills
Personal Growth/Self-Discovery
Other (Please specify):
What are your top 3 specific goals for our coaching sessions?
What does success look like to you at the end of our coaching engagement?
What challenges or obstacles have you faced in achieving these goals in the past?
What strengths and resources do you believe you possess that will help you achieve your goals?
On a scale of 1-10 (1 being not at all, 10 being extremely), how committed are you to achieving your goals?
What are your expectations for the coaching process?
Please review the following coaching services we offer and indicate your interest:
Core Personal Development Program (e.g., 3-month program): Focuses on foundational personal growth, goal setting, and overcoming limiting beliefs.
Career Advancement Coaching: Tailored support for career transitions, leadership development, and professional growth.
Relationship Mastery Coaching: Focuses on improving communication, building healthy relationships, and resolving conflicts.
Stress & Well-being Coaching: Techniques for managing stress, improving mindfulness, and enhancing overall well-being.
Customized Coaching Packages: Tailored to specific needs and goals.
Personal Growth Group Program (e.g., 6-week program): A structured program with a small group, focusing on shared personal development themes.
Leadership Development Group: Designed for professionals seeking to enhance their leadership skills and effectiveness.
Goal Setting & Accountability Group: Provides support and accountability for achieving specific goals in a group setting.
Workshop/Seminar (e.g., Half-day/Full-day): Intensive sessions on specific topics related to personal development.
Which of the above services are you most interested in?
Why are you interested in these particular services?
Do you prefer individual or group coaching?
individual
group coaching
Are you comfortable sharing your experiences and goals in a group setting (if applicable)?
What is your preferred coaching format?
in-person
virtual
phone
What is your preferred coaching schedule and frequency?
What is your budget for coaching services?
Do you have any specific learning styles or preferences that would be helpful for me to know?
Are you currently working with any other therapists, counselors, or coaches?
If so, please provide details.
Are there any medical or psychological conditions that may impact your coaching experience? (This information will be kept confidential.)
Are there any other factors that you believe are important for me to consider when working with you?
Are you willing to commit to the time, effort, and financial investment required for coaching?
Are you willing to be open, honest, and receptive to feedback during the coaching process?
Do you understand that coaching is a collaborative process and that your active participation is essential for success?
Are you willing to complete assigned tasks and exercises between coaching sessions?
Confidentiality: All information shared during coaching sessions will be kept strictly confidential unless required by law.
Payment: Details of payment terms and conditions will be provided separately.
Cancellation Policy: Details of cancellation and rescheduling policies will be provided separately.
Agreement: By signing this form, you acknowledge that you have read, understood, and agree to the terms and conditions of coaching.
Signature:
Client Intake Form Insights
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Let's break down this client intake form section by section, analyzing its purpose and effectiveness:
By using this intake form as a foundation and making necessary adjustments, you can create a valuable tool for building strong and effective coaching relationships.
Mandatory Questions Recommendation
Please remove this mandatory questions recommendation section before publishing.
Identifying "mandatory" questions on any client intake form is crucial for both practical and ethical reasons. For the Personal Development Coaching Client Intake Form you've provided, here are the questions that are generally considered mandatory, along with the "why" for each:
While other questions on the form provide valuable insights (e.g., past challenges, strengths, learning styles), the ones listed above are the absolute minimum required to safely, effectively, and professionally initiate a coaching relationship. Without them, you lack essential client information, a clear understanding of their needs, an assessment of their readiness, or the necessary ethical and logistical framework.
To configure an element, select it on the form.