top of page
Home
Coaching Readiness Assessment
Mindfulness Techniques and Strategies
Booking
Applying Mindfulness
Desired Emotions to Target
Applying Mindfulness in Real Life
About
Subscribe to Mailing List
Call
Email
Life Coaching for Greater Inner Peace Through Mindfulness
Coaching Readiness Assessment
Are you ready for life coaching?
Take this short assessment and find out.
First name
*
Last name
Phone
Email
*
Why are you seeking life coaching at this time? Select all that apply.
*
I'm looking for an alternative that might bring relief in ways I haven't been able to access.
I'm frustrated with other techniques because they feel forced.
I'm seeking change in multiple areas that I'm hoping life coaching can address all at once.
I feel like I'm always trying to change.
I want to be truly happy.
Which areas of your life would you like to strengthen? Select all that apply.
*
Relief from emotional paralysis
Deliberateness of thought for greater concentration
Greater self-awareness
Increased effectiveness in any area
My perception of myself
Getting along with others
How does the term mindfulness resonate with you?
*
It's word people say when they mean pay attention.
I want to learn it so that I can see if it's something that might work for me.
I'm hesitant and don't know if it's for me.
If it's a practice, there must be something to it.
Feelings of emptiness
Other
What is your degree of enthusiasm when seeking change through a less traditional method than affirmations and positive thinking?
*
Curious
Looking for the relief of a different approach
Very enthused about learning something that can make a true diffrence in changing my life
Very excited to try something new
Willing but not excited
Other
What emotions would you like to increase? Select all that apply.
*
Serenity
Emotional evenness
Feeling of stability
General happiness
Feeling of consistency
Ease in my relationships
Joy
Other
What emotions would you like to decrease? Select all that apply.
*
Anxiety
Depression
General sense of unhappiness
Fear
Helplessness/hopelessness
Trapped
Repressed
Feelings of emptiness
Other
To what degree do you observe your thoughts, as opposed to feel and become them?
*
I can separate the two.
I get sucked in emotionally very quickly to whatever stressor presented to me.
When I try to distract, negative emotions such as fear get stronger.
I can distract myself or I don't feel strongly upset.
Other
What types of relationships would you like to see enhanced? Select all that apply.
*
Family
Friendships/Social
Work colleagues
Business
My clients
Perception of self
Other
Are you ready for coaching?
*
Yes
No
Not sure
Need more info
Will you incorporate coaching tools in your daily life?
*
Definitely
I'll try to remember
Probably not
I don't know
I will make every effort
Other
What venues would you and/or your colleagues like to receive coaching?
*
Online
In Person
Speaking engagements
Corporate training
How close are you being ready to start?
*
Very close
Giving more thought
Ready to start
I understand that coaching is not a substitute for therapy if therapy is needed. I understand that the decision to get or stay in therapy is between myself and my licensed mental health professional and/or medical professional.
*
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
Submit
bottom of page