Pre-Coaching Assessment

First Name*
Last Name*
Job Title*
Company*
Email Address*
% : Goals Achieved YTD*
1. Have you ever worked with an executive coach or personal coach?*
2. What have you always wanted to do but been afraid to try and why?*
3. If you were to start a company from scratch, what values would you build it on? List a minimum of 4, maximum of 6*
4. What can a leader do to cause their people to be successful?*
5. What got you started in your current role?*
6. What keeps you in your current role?*
7. Define your role from your perspective.*
8. Define your role from your customer's perspective.*
9. Define your role from your company's perspective.*
10. What's keeping you from reaching balance across the various professional and personal roles you play?*
11. In your own words, what's the mission and vision of your company?*
12. In order of importance how do you like being rewarded, please write top to bottom (Renumeration, Respect, Recognition, Responsibility):*
13. How does the organization promote work-life balance for its employees?*
14. Which opportunities for learning new skills have you recently pursued away from the office?*
15. What is the one thing about your products or services that you would improve?*
16. In a single sentence, describe what your company does.*
17. In a single sentence, describe how your company does it better.*
18. What matters most to you in life and why?*
19. Is there any clarification you need about any of the questions that were just asked?*
20. What is your single most important personal and professional goal at this stage in your life?*

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