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Confidential Coaching Strategy Session

High Performance Coaching Questionnaire

Goal: To help you reach heightened levels of clarity, energy, courage, productivity, and influence on your march to a successful, healthy, and fully charged life.

Instructions: Please answer the questions to the best of your ability (you can skip any or only partially answer as you prefer) before our call. The questions help me get to know your goals, as well as where you currently see yourself with the Focal Points of clarity, energy, courage, productivity and influence. We’ll also explore the six pillars of High Performance: psychology, physiology, productivity, persuasion, presence, and purpose. Thank you.

Rolf Foster-Jorgensen, President
Optimire Consulting and Training Inc
Certified High Performance Coach - inaugural cohort & "coach's coaching ambassador"

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Demographics

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Question 2 of 35

Your Full Name

Question 3 of 35

Best Email Address

Question 4 of 35

Zoom and/or Skype User Name

Question 5 of 35

Phone Number(s)

Question 6 of 35

Mailing Address

Question 7 of 35

City

Question 8 of 35

Province/State

Question 9 of 35

Country

Question 10 of 35

Postal Code/Zip

Question 11 of 35

Gender (optional)

Question 12 of 35

Age (optional)

Question 13 of 35

Occupation and Title

Question 14 of 35

Employer

Question 15 of 35

How did you learn about my coaching services?

(Select all that apply)
A

Past Experience with Rolf

B

Personal Development choice

C

Referral by friend/family

D

Testimonial from colleague/co-worker

E

Assigned by Supervisor

F

Website

G

Online Advertising

H

Media Story

I

Other

High Performance Questions

Please rate yourself in the following areas of your life on a scale of 1 (lowest) to 10 (highest)

Question 17 of 35

Clarity: Do you feel you are clear about who you are, your purpose, and the direction you want to go in life?

A

1

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

9

J

10

Question 18 of 35

Energy: Do you consistently have enough mental and physical energy needed to excel, accomplish your goals, and feel motivated and happy?

 

 

 

A

1

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

9

J

10

Question 19 of 35

Courage: Do you take action and consistently express who you truly are and what you truly think, need, and desire with the world?

 

 

 

A

1

B

2

C

3

D

4

E

5

F

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G

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10

Question 20 of 35

Productivity: Are you consistently focused and effective, and are you good at minimizing distractions and maintaining priorities?   

A

1

B

2

C

3

D

4

E

5

F

6

G

7

H

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I

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10

Question 21 of 35

Influence: Do you feel you have the social influence with your family, friends, and team needed to accomplish your goals?

A

1

B

2

C

3

D

4

E

5

F

6

G

7

H

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I

9

J

10

General Questions

Please elaborate as you wish, to help us both determine whether and how we might proceed with possible High Performance Coaching

Question 23 of 35

1. What do you do for a living, and why did you choose that career? 

Question 24 of 35

2. What are the top 3 goals you are striving to achieve in your life and career right now?

Question 25 of 35

3. If you really pushed yourself, what one single goal would you most wish for in the next year?

Question 26 of 35

4. What major stressors and challenges are you struggling with right now?

Question 27 of 35

5. When you feel like your most successful and happy self, what makes you feel that way?

Question 28 of 35

6. What would your dream life look like if you could wave a wand and make it happen? 

Question 29 of 35

7. What has prevented you from having that dream?

Question 30 of 35

8. What goal or dreams have you ever given up on or failed at, and what do you believe caused you to stop or fail?

Question 31 of 35

9. What 3 big changes would you like to make in your life this year and next year?

Question 32 of 35

10. What are you most proud of and excited about in your life right now?    

Question 33 of 35

11. Why would you like to work with a high performance coach?

Question 34 of 35

12. Why do you feel you could be a great student or coaching client if we worked together?

Rolf Foster-Jorgensen

[email protected]
©2013-2018 Optimire Consulting and Training Inc 
Source: This tool is based on proprietary concepts from High Performance Institute’s Certified High Performance Coach Program™. Do not duplicate or distribute without permission.    

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