Connie Komack LifeWork Enterprises: Coaching Preview Form

Connie Komack
LifeWork Enterprises

COACHING • CONSULTING • TRAINING & DEVELOPMENT • SPEAKING • WRITING

Coaching Preview Form

Please complete this form and return it to me at least two days before our first scheduled session together. Your answers will help us to focus this session.

Asterisks (*) indicate required fields.

Name:	*
Date:	*
Company:
Title:
Address:	*
City:	*
State/Province:	*
Zip/Postal Code:	*
Country:	*
Day Phone:	*
Evening Phone:	*
Fax:
Email:	*

1. What is/are your reason(s) for seeking coaching at this time? *

2. What are three Life or Work goals you have for yourself at this time? Rank them in order of priority. *

3. Describe three successes you have had this past week: *

4. Describe one challenge you had this week and how you handled it: *

5. What one thing would you most like to achieve in our first session together? *

6. What questions do you have about coaching in general, about me, or about how we might work together? *

7. How did you hear about me and/or about this site? *

When you have completed the form, print a copy for your records and then click on Submit.

If we have not already set a date and time for our first session, please call me at 978-546-9660 or email me now. I look forward to meeting you and working with you.

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© 2005 Connie Komack / LifeWork Enterprises™
P.O. Box 371, Rockport, MA 01966
Phone: 978-546-9660 | Fax: 978-231-0589
Email: connie@conniekomack.com
Web: www.conniekomack.com

© 2005 Connie Komack / LifeWork Enterprises™ P.O. Box 371, Rockport, MA 01966 Phone: 978-546-9660 | Fax: 978-231-0589 Email: connie@conniekomack.com Web: www.conniekomack.com

© 2005 Connie Komack / LifeWork Enterprises™
P.O. Box 371, Rockport, MA 01966
Phone: 978-546-9660 | Fax: 978-231-0589
Email: connie@conniekomack.com
Web: www.conniekomack.com