Intake Packet

JEWEL COACHING & MENTORING

Arlene Cohen Miller, J.D.

Intake Packet

Sit comfortably, feet flat on the floor, spine straight.  Breathe, relax and be with yourself.  Choose to be fully present and open to sharing whatever comes to you.

Please ponder and respond to the questions below.  Please e-mail me your responses at least two (2) days prior to our first session.    This information will help us to make the most of our time together.  All of your responses are confidential to the fullest extent allowable by law.

List your three most important goals for coaching

1)

2)

3)

List up to seven other goals that are important to you

1)

2)

3)

4)

5)

6)

7)

What is the single most important result you want to accomplish?

What is the cost of not accomplishing this result? Please consider the cost to you (both personally and professionally), to those close to you, and, as appropriate, to your team, your customers, your organization, and beyond.

What would be the benefit of accomplishing this result? Please consider the benefit to you (both personally and professionally), to those close to you, and, as appropriate, to your team, your customers, and beyond.

How high a priority is this result for you at this time? Is it something you would like to do, something you should do, something you feel compelled to do, something you are committed to doing, etc.

What are the 10 most important things for me to know about you?

1)

2)

3)

4)

5)

6)

7)

8)

9)

10)

Do you have a personal vision for your life? If so, what is it?





Do you have a professional vision for your work life? If so, what is it?






What are your personal and professional strengths?

1)

2)

3)

4)

5)

6)

7)

8)

9)

10)

What are your current external challenges? What are you dealing with right now that needs immediate attention or resolution?

1)

2)

3)

4)

5)

6)

7)

8)

9)

10)

What are your inner challenges, blind spots, areas most in need of development? What is it about you that stops you or makes it difficult for you to achieve or exceed your goals?

1)

2)

3)

4)

5)

6)

7)

8)

9)

10)

What are your personal values, your core values? What is most important to you?

1)

2)

3)

4)

5)

6)

7)

8)

9)

10)

What “self-care” activities do you do on a regular basis that keep you physically, mentally, emotionally, and spiritually balanced?

1)

2)

3)

4)

5)

6)

7)

8)

9)

10)

What would help you become more physically, mentally, emotionally, and spiritually balanced?

1)

2)

3)

4)

5)

6)

7)

8)

9)

10)

Coaching is about moving forward from the present.  At the same time, our history plays a major role in shaping who we are, both in defining our strengths and in creating patterns that can tend to get in our way. Is there anything you’d like to share about your past that still impacts you, and that would be useful for me to know as your Coach?

1) Where energizes you in life?

2) What (if anything) drains your energy? What consumes your time that doesn’t serve you or your vision?

3) In what ways do you honor yourself and your core values?

4) In what ways (if any) do you not honor yourself and your core values?

5) If you knew you couldn’t fail, what would you most like to do?

6) What do you notice about people who excel at what they do? What distinguishes them from their peers?

7) What do you notice about people who don’t achieve what they are capable of?

8) What are you most proud of?

9) What (if anything) do you most regret not doing?

10) What was the best advice you’ve ever been given and how has it affected you?

If applicable:  Describe the organizational culture in which you’re currently working, including its strengths, challenges, and values. What do you most appreciate about it? What would you most like to change about it?

What would a great coaching session look like / feel like / be like for you? What are you most looking for during our times together?

Do you like sessions to be highly structured or less structured? Is it important for you to have a sense of linear progress toward a clear goal, or are you sometimes content with a more free flow of ideas?

Do you prefer a slow, moderate or fast pace? Or no predetermined pace?

Do you want our focus to be business only? Professional development?  Professional  and personal? Only personal?

What else would you like from me as a coach?  Do you have any expectations?

Arlene Cohen Miller

Jewel Coaching & Mentoring

This e-mail address is being protected from spambots. You need JavaScript enabled to view it

720.936.2634

Jewel provides professional life coaching and mentoring services in Longmont, Boulder and Denver, Colorado and around the world!  At The Shop, we feature The Looking Glass of Love e-book (a must read for parents) and a Message of the Day App for your iphone and android ... to uplift and inspire you!