Confidential Client Information
Name (First & Last):
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Who Referred You To Our Company:
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Birth Date
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Height (in feet)
Blood Type*
Birth Weight (if known)
Current Weight
Ideal Weight
Weight One Year Ago
Would you like your weight to be different?
Family/Living Situation
How many people live in your home?
Children and Their Ages
Occupation
Hobbies
Last book you read?
1. What would you like to accomplish during your first coaching call meeting?
2. Please share 3 things in your personal/professional life of which you are most proud.
3. What BARRIERS do you have with creating the changes in your life you desire?
4. What things do you feel you will have to change about yourself to create the life you wish to have within the next 3 to 9 months? Please describe:
5. The reasons it won’t be easy for you to make these personal changes:
6. What are [number] changes you would like to make in your life over the next [number] years?
7. What will get in your way of making these changes?
8. What habits, attitudes, and emotions will be important for you to release to manifest the life you wish?
9. What do you value most in your life right now?
10. What changes would you like to see in your life, dating, or relationship? What do you feel is hindering you the most from making those changes?
11. Do you have repeating patterns and habits you would like to change?
12. What short-term goals would you like to accomplish over the next [number] months?
13. Why do you want to achieve what you want to achieve?
14. What would you consider the primary reason you are seeking Life Coaching Services?
15. What kind of life do you envision for yourself and your family?
16. What is your perfect vision of an awesome life?
17. Why are you looking to improve your life?
19. How would you feel if you were living your dream life?
20. What is causing you not to make a life change at this time?
21. On a scale of 1 to 10, how would you rate your current happiness level?
22. What makes you the happiest currently in your life?
23. On a scale of 1 to 10, how would you rate your current stress level? What is causing you stress?
24. What is the most challenging obstacle you have had to overcome in your life thus far? How did you overcome it?
25. What has been your biggest success in your life thus far? How did you achieve it?
26. What are [number] things you feel are hindering you from [happiness, fulfillment, motivation, etc]?
27. What does success look like to you?
28. What changes would you like to see in your life? What do you feel is hindering you the most from making those changes?
29. Who are the most important people in your life, and what is your relationship to them?
30. What do you value most in your life right now?
31. What previous steps have you already taken to achieve your goals? What has been the result so far, and what have you learned?
32. Where do you see yourself [amount of time] from now, when this program is over? What do you think it will take to get there?
33. Do you have what is considered a high credit score? If so, what is your score?
There's more than one credit scoring model available and more than one range of scores. However, most credit score ranges are similar to the following:
800 To 850: Excellent
ndividuals in this range are considered to be low-risk borrowers. They may have an easier time securing a loan than borrowers with lower scores.
740 To 799: Very Good
Individuals in this range have demonstrated a history of positive credit behavior and may have an easier time being approved for additional credit.
670 To 739: Good
Lenders generally view those with credit scores of 670 and up as acceptable or lower-risk borrowers.
580 To 669: Fair
Individuals in this category are often considered “subprime” borrowers. Lenders may consider them higher-risk, and they may have trouble qualifying for new credit.
300 To 579: Poor
Individuals in this range often have difficulty being approved for new credit. If you find yourself in the poor category, it's likely you'll need to take steps to improve your credit scores before you can secure any new credit.
If not, what is stopping you from becoming financially secure?
34. On a scale of 1 to 10, how would you rate your current stress level? What is causing you stress?
35. Who are the most important people in your life, and what is your relationship with them?
How did you hear about us?
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