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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.

1. What SCORE out of 10 would you give for how SATISFIED you are with your life overall? 12345678910
2. If you were to give a SCORE out of 10 for how much JOY you're having in life: 12345678910
3. If you were to give a SCORE out of 10 for how FULFILLED you are in your current CAREER: 12345678910
4. Give a SCORE out of 10 for how overwhelmed, BUSY or stressed you usually feel: 12345678910
5. Deep down, I like myself: 12345678910
6. What is your FAVORITE thing in life at the moment? (like best)

7. What could be IMPROVED in your life at the moment? (like least)

8. Thinking about coaching, I am looking: (Hold down your CTRL key to select more than one.)
For More Meaning/Purpose in LifeFor More Fulfillment/Happiness in LifeFor More Ease/Simplicity or Balance in LifeFor More Freedom and/or Inner Peace in LifeTo Change or Move Forwards in my CareerTo Achieve my Goals Faster/More EasilyTo Learn to Trust Myself More/Be My Authentic SelfAll of the AboveOther

If you selected "other," what would that be?

9. I am ready to take ACTION, and make changes in my environment, habits and life: MaybeYesNo