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Empowered Leadership Participant Questionnaire

(5-10 Minutes)

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Question 1 of 14

1. Please prioritize your motivation and focus for our coaching work together (select all that apply):

(Select all that apply)
A

Transformation for myself personally

B

Transformation for myself professionally

C

Breakthrough for my team/org for individual contributors’ performance or execution

D

Breakthrough for my team/org for team performance or execution

E

Empower wellness for specific individuals within my org

F

Empower wellness for my team or org collectively

Question 2 of 14

2. Whether you are looking for breakthrough transformation for yourself personally or professionally, or for your team/org; please elaborate on your single highest priority pain/problem, opportunity, or goal right now for a coaching relationship?

Question 3 of 14

3. Please state/elaborate on your second highest priority pain/problem, opportunity, or goal right now?

Question 4 of 14

4. Please state/elaborate on your third highest priority pain/problem, opportunity, or goal right now?

Question 5 of 14

5. What would you ideally experience through an engagement with an expert coach?

Question 6 of 14

6. If all obstacles were removed and your top priorities you listed were all addressed, and results were exactly as you would choose, how would it ideally look

Question 7 of 14

7. How would you rate your desire and commitment to change your situation right now?

A

1

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

9

J

10

Question 8 of 14

8. If the priorities you listed above were overcome/achieved, what would that outcome be worth to you?

A

$24k or Less

B

$25K - $95k

C

$100K - $999K

D

$1M or more

Question 9 of 14

9. Assuming you found the perfect solution to the above outcome, how would you describe your financial situation?

A

I have access to resources and I am willing to invest

B

I can be resourceful to find finances to invest

C

Even if I knew it would achieve the outcome, I have $0 to invest in the results

Question 10 of 14

10. Would a decision to get help in these areas be yours alone, or would someone else be involved in the financial decision?

A

Mine Alone

B

A business colleague

C

Spouse

D

Both B and C (Spouse & Colleague)

Question 11 of 14

11. If you found the perfect solution to these issues, would you want to start it right away?

A

Yes, ASAP

B

Soon, but not right now

C

Not for a while

Question 12 of 14

12. We really care about you and your business, and we want to serve those who take themselves (their personal lives) and their businesses seriously. Therefore, will you be committed to completing this program from start to finish?

A

Yes

B

No

Question 13 of 14

13. Is there anything you would like to share with us specifically to help us support you during your participation in this program? 

Question 14 of 14

14. If you could have any superpower, what would it be?

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