Coaching Intake Survey

Let's begin with what's real for you today.

These questions help us understand your current experience, what matters most, and where you're ready to grow.

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Confidentiality NoticeYour reflections are yours alone. Everything you share is kept in confidence and used only to support your journey.
Around 10–15 minutes  ·  Save and return any time
About you

Your name

Current state

What's most on your mind right now?*

This could be a challenge, opportunity, goal, or concern.

0 / 500
Where you want support

Where would you most like support during this coaching engagement?*

For each area, let me know how much support you feel you need right now.

1 — Not needed
2 — Would be helpful
3 — I'd benefit here
4 — Key focus area
Area1234
Is there any other area that you need support with?
0 / 300
What's working

What's going well that you'd love to build on?*

What's energising you or giving you a sense of momentum right now?

0 / 400
The harder question

Where do you feel stuck, held back, or unclear?*

This could be internal (mindset, confidence) or external (team, structure).

0 / 400
Your ideal outcome

What would make you look back at this coaching engagement and say, ‘That was a success’?*

Describe your ideal outcome from this coaching engagement.

0 / 400
Your sense of purpose

How connected do you feel to your sense of purpose or contribution?*

Not at allVery connected

What's one thing that gives you meaning at work or in life?*

0 / 300
One last question

What is one small change that if made would improve your experience as a leader?*

0 / 300
Review & confirm

One last look before you send.

Read through your responses. Edit anything that doesn't feel quite right, download a copy for yourself, then confirm to send to your coach.

Nothing is sent to your coach until you tap Confirm.
✓

Your intake is complete.

Thank you for taking the time to reflect honestly. Your responses have been saved.

Download a copy (PDF)