Welcome to my Mindset Coaching Questionnaire. Please fill out your answers as best as you can and be sure to submit at least one-business day before our scheduled call. This process calls for a deep-reflection, enjoy it. Personal Information Name * First Name Last Name Do you have a preferred name? Email * Phone * Country (###) ### #### What is your age? It's just a number! What is your occupation/what industry do you work in? If you have a LinkedIn profile, what is your profile name? If you have instagram, what is your handle? Are you currently seeing any mental health professionals? e.g., therapist or counselor Yes Not at this time Coaching Goals What motivated you to seek coaching? Please select all that apply. Personal Growth Career Advancement Confidence Building Something else? Please specify below: What are your primary coaching goals? Please select all that apply. Align your personal and professional life Overcome limiting beliefs Develop a confident precense Strengthen communication skills Improve decision making Something else? Please specify below: Please expand and describe the specific outcomes you hope to achieve through coaching: What is the biggest challenge you’re currently facing in reaching your goals? What is your timeline for seeing progress or achieving your goals? Is there perhaps a specific event you have in mind? Or a life change that may occur? Current Mindset and Challenges How would describe your current mindset? Please select all that apply. Optimistic Neutral Overwhelmed Something else? Please specify: Do you have any limiting beliefs or patterns you feel are holding you back? If so, please expand. On a scale of 1-10, how would you rate your self-confidence? 1-Low, 10-High 1 2 3 4 5 6 7 8 9 10 Do you have any habits or behaviours you with to address or change? Lifestyle and Preferences How do you typically spend your day? What are your preferred learning and communication styles? Please select all that apply. Visual (e.g., diagrams, vision boards) Auditory (e.g., discussions, verbal affirmations) Kinesthetic (e.g., hands-on activities, physical cues) Something else? Please specify below: * Do you have a structured routine or prefer a more flexible approach? Are there specific areas you’d like me to consider when tailoring the coaching sessions ? e.g., cultural, personal, or professional nuances Self-Image and Presentation How would you describe your current self-image? Do you feel your appearance aligns with your personal or professional goals? Yes No If no, please expand on what you'd like to improve or refine. Would you like to integrate style and presence coaching into your sessions? Commitment and Expectations Are you willing to commit to weekly. orbi-weekly sessions? Yes No Are there specific tools, resources, or exercises you’d like to use during coaching? What does success look like to you at the end of our coaching journey? Is there anything else you’d like to share that would help me understand your vision and challenges? By submitting this questionnaire, you acknowledge that the information provided is accurate to the best of your knowledge and will be used to create a personalized coaching experience. Thank you for taking the time to reflect, review and answers all of these questions. I very much look forward to our call. Should there be anything you forgot to include, feel free to send me an email at anthony@anthonytomizza.com
