Are You Ready to be Coached?

Name_______________________________________________________________

Mailing Address______________________________________________________

Home Phone_______________________  Work Phone______________________

Fax Number ________________________  E-mail Address___________________

Company______________________________Occupation____________________

This questionnaire is designed to help you self-assess your readiness for a coaching relationship. Please circle Yes or No to each question, and return to your coach within three business days. 

1. I know what I want to accomplish during the Coaching Program, and I am willing to focus on that goal.

                     Yes                                 No

2. I will set aside time to complete my coaching homework.

                    Yes                                  No  

3. I am willing to make calls to my Coach on the agreed upon days and times.

               Yes                                 No

4. I am willing to stop or change behaviors that are interfering with my progress.

            Yes                              No

5. I am willing to try new approaches to help me achieve my goals.

Yes                              No

6. I will take regular actions to help achieve my goals even if I don’t  see immediate

results.

            Yes                              No

     6. I will be open with my Coach about what I like or don’t like about how the coaching

         is going.

                         Yes                             No

     7. I will work collaboratively with my Coach to design goals and action steps to move

         forward.

                         Yes                             No