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SCSU Mindful Life Coaching Workshop Series – Week 6
1 | P a g e
© 2012 Healthy Wealthy and Wise Corporation
Certified Coaches Federation New Client Questionnaire
Question List
1) What do you want to achieve (in the next 12 months)?
Be Specific: Financially, Emotionally, Physically, Spiritually, Professionally and in your Relationships [Please address each relevant category and the following questions on the worksheet provided]
2) Look back at the goals you identified for Question 1: a. Time shift to when the goal has already been achieved. It is now [date] and you are
now [goal], what does achieving these goals mean to you? b. Be Specific: How do you feel? What does it look like? What do you hear? Please
address each goal.
3) If your goal is intangible, how will you know when you achieve each goal? What will you see, hear, and feel? (if your goal is tangible, go directly to Question 4)
4) How does achieving each of your goals impact other aspects of your life? When answering, please include family and other relationship.
5) What has prevented you from achieving these goals in the past?
6) What skills, tools and other resources do you currently have that will aid in your ability to achieve your goals?
7) What specific action steps can you take to achieve these goals?
8) What additional skills, tools, and resources do you need to develop to help you achieve your goals?
SCSU Mindful Life Coaching Workshop Series – Week 6
2 | P a g e
© 2012 Healthy Wealthy and Wise Corporation
Certified Coaches Federation New Client Questionnaire
Worksheet for Question 1
1) What do you want to achieve? Be specific.
Financially Emotionally Physically Spiritually Academically In Relationships
SCSU Mindful Life Coaching Workshop Series – Week 6
3 | P a g e
© 2012 Healthy Wealthy and Wise Corporation
Certified Coaches Federation New Client Questionnaire
Worksheet for Question 2
2) Look back at the goals you identified for Question 1: a. Time shift to when the goal has already been achieved. It is now _____________
and you are now _______________, what does achieving these goals mean to you? b. Be Specific: How do you feel? What does it look like? What do you hear? Please
address each goal.
SCSU Mindful Life Coaching Workshop Series – Week 6
4 | P a g e
© 2012 Healthy Wealthy and Wise Corporation
Certified Coaches Federation New Client Questionnaire
Worksheet for Question 3
3) Intangible Goals (E.g., more self-esteem, more confidence, etc.): How did you know when you achieved each goal? What did you see, hear, and feel? (For tangible goals, you may go directly to Question 4)
SCSU Mindful Life Coaching Workshop Series – Week 6
5 | P a g e
© 2012 Healthy Wealthy and Wise Corporation
Certified Coaches Federation New Client Questionnaire
Worksheet for Question 4
4) How did achieving each of your goals impact other aspects of your life? When answering, please include family and other relationship.
SCSU Mindful Life Coaching Workshop Series – Week 6
6 | P a g e
© 2012 Healthy Wealthy and Wise Corporation
Certified Coaches Federation New Client Questionnaire
Worksheet for Question 5
5) What has prevented you from achieving these goals in the past?
SCSU Mindful Life Coaching Workshop Series – Week 6
7 | P a g e
© 2012 Healthy Wealthy and Wise Corporation
Certified Coaches Federation New Client Questionnaire
Worksheet for Question 6
6) What skills, tools, and other resources do you currently have that aided in your ability to achieve your goals?
SCSU Mindful Life Coaching Workshop Series – Week 6
8 | P a g e
© 2012 Healthy Wealthy and Wise Corporation
Certified Coaches Federation New Client Questionnaire
Worksheet for Question 7
7) What specific action steps did you take to achieve these goals?
SCSU Mindful Life Coaching Workshop Series – Week 6
9 | P a g e
© 2012 Healthy Wealthy and Wise Corporation
Certified Coaches Federation New Client Questionnaire
Worksheet for Question 8
8) What additional skills, tools, and resources did you develop to help you achieve your goals?