Personal Coaching Survey

Please respond to each statement below by checking 1, 2, 3, 4, or 5.

The scale is as follows:

1 -Strongly Agree, 2 -Agree, 3 -Neutral, 4 -Disagree, 5 -Strongly Disagree

You may choose to submit your score at the bottom of this page.

I keep a healthy balance between my work life, home life, and other interests and activities.

1	2	3	4	5

The way I communicate builds good relationships in all areas of my life.

1	2	3	4	5

I am satisfied with my personal relationships. They satisfy my needs, and they are healthy and rewarding.

1	2	3	4	5

I take good care of my body in the way I eat and exercise.

1	2	3	4	5

I trust that my physical appearance and personal mannerisms make a positive impression when people meet me.

1	2	3	4	5

I include a healthy dose of fun and recreation in my life.

1	2	3	4	5

I am content with the degree to which I continue to learn new things and to grow personally and professionally.

1	2	3	4	5

When I know something is good for me, I act on it so that it becomes a regular part of my life.

1	2	3	4	5

I feel good that the way I make choices is consistent with what I say is important to me.

1	2	3	4	5

10.

My life matches the dreams I have for myself.

1	2	3	4	5

TOTAL SCORE:

1 - 25 Wow, what a life!
26 - 35 Your life could be improved by making changes in a few areas of dissatisfaction.
36 - 50 You may be experiencing great dissatisfaction in your life for reasons that are
clear to you or perhaps unclear. Let's explore how things could be different.

Name:
Phone:
Email:

Personal coaching can help you to identify new directions, develop new skills, and motivate you to do things that will result in a greater sense of balance, effectiveness, and fulfillment.

Please click on "Personal Coaching" in the menu to read a description of the coaching options that might be of value to you. If you're interested specifically in career coaching or relationship coaching, click on those for more information. Check out the group coaching option as well as the individual coaching option.