Coaching Questionnaire


“Our greatest fear as individuals and as a church should not be of failure, but of succeeding at things in life that don’t really matter.” – Tim Kizziar

WARNING: This form does NOT auto save. Please do not refresh the page, close this window, or hit the foreword or back button. Optionally, you can download this form below(1), fill it in and then upload(2) it by clicking on the buttons bellow. You could also do the questions offline and then cut and paste your answers into the form below.

1. Download Form 2. Upload Form

Thanks for your interest in life coaching.  Please fill out the form below.  An email will be sent to Kathy as well as a copy sent to yourself.

First Name*

Last Name*

Your Email*

  1. What is your vision of your ideal life work?

  2. Where do you see yourself 5 years from now?

  3. What are the success factors that you deem important to feel a sense of significance?

  4. What does success/finishing strong mean to you?

  5. What is the biggest challenge you’ve ever faced?

  6. What did you do about it?

  7. What's the biggest challenge you're experiencing right now?

  8. What do you need to do most, right now?

  9. What are you “putting up with” (tolerating) at this time?

  10. What is your biggest fear?

  11. What challenges keep you awake at night?

  12. What responsibilities drain you of energy?

  13. Which relationships deplete and frustrate you?

  14. Which relationships energize you?

  15. What are you most passionate about?