Creating Fulfillment in Your Life Forms LIFE COACHING INTAKE ASSESSMENT Your Name (required) Your Email (required) Your phone (optional) CREATING FULFILLMENT IN YOUR LIFE In our coaching together, my goal is to support and empower you to create a more fulfilled life. Self-evaluating is the first step in identifying the areas you want to improve upon and one of the most crucial parts of growth and transformation. Please rate each category below, scoring 1 – 10 to each item independently. # 1 is the lowest level of satisfaction while a # 10 is the highest level of satisfaction. Rate from 1 – 10 Self Confidence 12345678910 Significant Other 12345678910 Career 12345678910 Family 12345678910 Friends 12345678910 Physical Health and Well Being 12345678910 Emotional Health and Well Being 12345678910 Physical Environment 12345678910 Finances 12345678910 Spirituality/Religion 12345678910 Education/Personal Growth 12345678910 Fun and Leisure 12345678910 Lifestyle 12345678910 Personal Joy 12345678910 Balance in Life 12345678910 Describe in more detail the top 3 areas you’d most like to focus on. Focus Area 1 of 3 Focus Area 2 of 3 Focus Area 3 of 3 What would you have to do or change to make these things happen in the next 30-90 days? How will you know when you have achieved these goals? How best can I coach you? i.e.: Direct questions, accountability assignments, feedback, all of the above. Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is - His good, pleasing and perfect will. Romans 12:2 Intake Assessment | 661-241-0575 | info@sallybetters.comSally Betters, CLC © The Transformed Life LLC Share Tweet +1 Share Pin