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High Performance Questionnaire for Discovery Session

Please fill out this questionnaire application before scheduling your Discovery Session.

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

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Instruction

1. Please take your time to answer each question to your best ability. This is for you and your future.

2. Unfortunately our system will not allow you to go back to the previous question. This means you have to answer in the order given. If you are not sure about your answer yet please enter "not sure yet" in the box. The box can not be left blank.

 

Question 2 of 31

Your Full Name

Question 3 of 31

Gender

A

Female

B

Male

C

Other

D

Prefer not to answer

Question 4 of 31

Please provide your address to complete your contact info.

Question 5 of 31

My Occupation is

Question 6 of 31

Relationship Status

A

Single

B

In Relationship

C

Married

D

Divorced

E

Windowed

Question 7 of 31

Please briefly describe how you heard about my coaching services and why you would like a Discovery Session with me:

Question 8 of 31

Clarity: Do you feel you are clear about who you are, your purpose, and the direction you want to go in life? Please rate yourself in the following areas of your life on a scale of 1 (lowest) to 10 (highest).

Question 9 of 31

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

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

Question 10 of 31

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

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

Question 11 of 31

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

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

Question 12 of 31

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

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

Question 13 of 31

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

Question 14 of 31

2. What are your top 3 goals you are striving to achieve right now?

Question 15 of 31

3. What major stressors or challenges are you struggling with right now

Question 16 of 31

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

Question 17 of 31

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

Question 18 of 31

6. What else has prevented you from having that dream life?

Question 19 of 31

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

Question 20 of 31

8. What 3 big changes would you like to make in your life in the next 12 months?

Question 21 of 31

9. What are you most proud of and excited about in your life?

High Performance Questions:

Remember to take your time.

Question 23 of 31

1. What negative recurring thoughts, fears, or behaviors would you like to overcome in order to feel more psychologically free, confident and successful?

Question 24 of 31

2. What eating, exercise or general health habits would you like to begin or break in order to feel stronger and more healthy physiologically?

Question 25 of 31

3. What distracts you the most from being more productive, and what major projects or missions are you struggling to complete faster or more efficiently?

Question 26 of 31

4. If you were more persuasive or influential, what dream or desire would you ask others to support you in achieving?

Question 27 of 31

5. When do you struggle to be fully present in your day or in any of your relationships?

Question 28 of 31

6. How purposeful do you feel in living each day, and how would you describe your purpose?

Question 29 of 31

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

Question 30 of 31

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

Soure: 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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