“Our chief want in life is somebody who will make us do what we can.”  Ralph Waldo Emerson

Is Coaching for you?

Please fill out the attached form and submit it for a free introductory coaching session to find out what coaching can do for you.

On a scale of 1 to 10, rate each of the following statement (if not applicable, score the item a 5).

1 2 3
Not at all agree

4 5 6 7
Somewhat Agree

8 9 10
Totally Agree

Your Score

I am ready to create more balance in my life

1 2 3 4 5 6 7 8 9 10

I am ready to improve my personal or business relationships

1 2 3 4 5 6 7 8 9 10

I am ready to make real and positive changes in my life

1 2 3 4 5 6 7 8 9 10

I am ready and willing to overcome self-limiting behavior

1 2 3 4 5 6 7 8 9 10

I am ready to create and take action to achieve my goals

1 2 3 4 5 6 7 8 9 10

I am ready to achieve a sense of fulfillment at work and in life

1 2 3 4 5 6 7 8 9 10

I am ready for more fun and enjoyment in my life

1 2 3 4 5 6 7 8 9 10

I’d like to work less and make more

1 2 3 4 5 6 7 8 9 10

I can benefit from someone who will help me to stay on track

1 2 3 4 5 6 7 8 9 10

 Your Total

YOUR SCORE

Under 30
Coaching is not for you right now.

31 to 60
Coaching could help you to look at your life from a different viewpoint as well as help you develop a plan to change what it is that you would like to change.  However, if you decide to work with a coach now, you should decide and commit that you will take the necessary action for your benefit, or you will not make life-changing improvements.

Over 60
You are ready for a coach right now!  You are willing to do whatever it takes to create the life you deserve and desire.

SUCCESS COMES WHEN YOU CHANGE WISHING INTO DOING!

© 2001 iPEC Coaching