Coaching Intake Form Step 1/7: Leave this field blank Personal Details Name Mobile Number Email Email Coaching Newsletter I agree to receive coaching emails and news about new services, events and offers etc from Simon Lee Maryan Ltd. Understanding Your Current Situation How would you describe your current life situation in a few sentences? What are the three most significant aspects of your life right now (e.g., career, family, health)? What feelings or emotions do you most often experience daily? What are your biggest challenges or struggles at the moment? How do you spend a typical day, and how does this align with your values and interests? What aspects of your life do you find most fulfilling? Least fulfilling? How do you react to unexpected challenges or stressors? Vision For Your Future If you could envision the ideal version of your life in five years, what would it look like? What goals or dreams have you put on hold, and why? What does success mean to you, and how would you know you’ve achieved it? Are there any roles or identities you aspire to adopt or expand upon in the future (e.g., leader, advocate, mentor)? What are some things you’ve always wanted to do but haven’t yet started? How does your future self differ from who you are today? Identifying Obstacles What do you feel is holding you back from achieving your dreams or goals? Can you identify any fears or beliefs that might be limiting your potential? How do you typically deal with failure or setbacks? In what areas of your life do you feel the least confident or capable? Are there any external circumstances or people you believe are influencing your current situation negatively? How do you prioritise your time and energy, and do these priorities reflect your true objectives? Pathways to Change What steps have you taken in the past to change your situation, and what were the outcomes? What resources (time, money, support networks) do you currently have at your disposal that could aid in your transformation? Who in your life supports your growth, and how do they do so? What are you willing to sacrifice or change in your life to achieve your goals? How do you learn best, and how can this style be applied to your transformation process? Can you think of a time when you successfully overcame a challenge? What did you learn from that experience? Commitment and Motivation On a scale of 0-10, how committed are you to making significant changes in your life? 5 What motivates you to get out of bed every morning, and how can we harness this motivation towards your goals? How do you define personal growth, and what areas of growth are most important to you? What are you most passionate about, and how can we integrate this passion into your life goals? How do you envision a coaching relationship helping you to overcome your current challenges? What are the first steps you feel ready to take towards transformation? Sign Here to Agree That You Are Ready To Commit To Yourself and The Process. Start drawing Clear Done Start over Continue
