“The road to your destiny starts right here. All you need to do is take the first step. Then the next. Just focus. Just breathe. Just begin.” -Anonymous.

Welcome to the first step to change and taking action toward creating your life the way you really want it. I am fiercely devoted to you REALLY living and loving your life. This assessment will help us both connect to your deepest desires and consciously call out any blocks that are keeping you from having what you want. It’s also going to help you get really clear about what you want.

What could be better than that?

Please fill out the information below, it will be essential to receiving results from our coaching relationship.

Your life is made up of approximately 120 waking hours per week. What you do with these hours is your life. In this assessment you will explore in detail how you have been spending your life. Later, in this assessment you will look into what else you could be up to and discover your true desires.

Please take your time to fill this out completely and honestly. Even if you don’t have what you feel would be the best answer to the question, please answer EVERY question to the best of your ability. YOU MUST COMPLETE AND RETURN BEFORE YOUR FIRST COACHING SESSION

DISCOVERY 1: YOUR LIFE FOCUS

Name

First Name

Last Name

Email Address

Phone

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday

YYYY

1. What do you do to make money and pay your bills? Are you passionate about what you do to create income?

2. Approximately how many hours do you work per week?

3. List your free time activities and the hours you spend on these per week.

4. How many hours per week do you spend with... Family, Friends, Significant other...

5. What other baby or child oriented activities (classes, groups, music together...) are you devoted to? List the hours you spend on each per week. Activity.

6. How many hours do you spend... Networking with or helping your community? Improving or maintaining your fitness or overall health? In your spiritual life? In personal development/self-improvement? Organizing or cleaning your physical environment? Recreational Activities? Working on your physical appearance, shopping, thinking about how you dress, your hair? Improving your personal relationships?

7. List all activities or pastimes that you currently DON'T participate in, but you promise yourself you will do a lot of "someday." What consistent lifestyles would you take on if you won the lottery? What would you pursue if success was guaranteed? These should be things you would be interested in having as a regular part of your life, not just something to "try out" once.

DISCOVERY 1: YOUR LIFE FOCUS

List the emotions that are most important for you to feel in life. These are not external achievements like "car" or "family." Rather, they are internal emotions such as "love" or JANUARY 82 "passion" or "captivating." If one of these emotions obviously stands out as most important in your life, enter it below.

How often do you experience this emotion? In what circumstances or situations do you experience this emotion? In each situation, note the duration of the emotion, and rate the intensity on a scale of 1-10 (least to most) Situation Duration Intensity (1-10)

List the negative emotions that you wish to avoid in your life. Ex. "fear,” "anger," "loneliness." If one of these stands out as the worst emotion you could imagine (the one you would do the most to avoid), enter it in the space below.

Why would you like to most avoid this emotion?

List the major defining moments in your life. These are events that changed everything for you, or after which "nothing was the same." Include what you would define as the best and worst experiences of your life. Most of these moments will have some emotional intensity around them and be easily remembered. Be honest. Trying to look good here will not serve you in your development and opening up to vulnerability will allow you to be truly seen and heard.

What is the most important relationship in your life? Why is it the most important?

What is the most significant missing piece in your life? Why do you say that?

What causes you the most stress? Why is that stressful?

What do you deserve in life? What don't you deserve? Why/Why not?

How do you get out of stress? In what areas of your life are you totally comfortable and self- assured? What causes you to feel certainty/ lack of it?

What motivates you most in life?

What are the biggest opportunities or challenges coming up in your life?

What do you want from a Coach?

Why is now the best time to follow through on your goals?

CONGRATULATIONS, YOU’RE DONE

Now you are ready to take the driver’s seat and I’m here to support you with every turn of the wheel.

Put the pedal to the metal baby, it’s your turn!

New Client Assessment

“The road to your destiny starts right here. All you need to do is take the first step. Then the next. Just focus. Just breathe. Just begin.” -Anonymous.

DISCOVERY 1: YOUR LIFE FOCUS

DISCOVERY 1: YOUR LIFE FOCUS

CONGRATULATIONS, YOU’RE DONE

Now you are ready to take the driver’s seat and I’m here to support you with every turn of the wheel.

Mom-ME Circle