1
I am willing to participate in the coaching process as part of my personal investment in myself. I believe coaching to be a solution to creating changes in my life. I am not looking for a quick fix.
 Yes
 No
2
I have a strong desire to improve myself now.
 Yes
 No
3
I have an idea of my goals and how coaching might impact them.
 Yes
 No
4
I can identify the benefits of reaching these goals.
 Yes
 No
5
I am willing to give up or shift any self-defeating behaviours that are creating a barrier to my success.
 Yes
 No
6
I view coaching as a worthwhile investment in me, not as an "expense", and I will not allow finances to be a barrier to my coaching.
 Yes
 No
7
I am able to make the commitment of time needed to make and keep my scheduled coaching appointments, and to be accountable for doing any homework my coach asks of me.
 Yes
 No
8
I can be honest with myself.
 Yes
 No
9
I am open to new ways of thinking and behaving.
 Yes
 No
10
This is the appropriate time in my life for me to accept coaching.
 Yes
 No