CLIENT PROFILE COACHING I look forward to going through your answers to these questions and from this information I will be able to gather the right approach for our coaching. As you search your mind and heart for the answers to these questions you will develop language to help you express deep thoughts and feelings. So take your time and answer them over a couple of days if needed. Don’t rush as they help you find out what is really important in your life and how you can continue to flourish and expand your influence and power. “Knowing thyself is the beginning of wisdom” AristotleCLIENT PROFILEName(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home PhoneMobile(Required)Email(Required) EMPLOYMENT INFORMATIONTitle(Required)Employer(Required)Work PhonePERSONAL INFORMATIONDate of Birth(Required) DD slash MM slash YYYY Marital StatusChildrenAs your coach it is important for me to understand how you view the world in general and yourself in particular. Every person has their own unique and personal way of interacting with their surroundings. These questions will hopefully provide a means for me to understand you and your current position more closely and thus enable me to coach you to bring out your best. Please take some time to answer these questions as thoughtfully and clearly as possible. These questions are designed to be “mulled over” and to stimulate your thinking on items that may in the past been automatic. If you have any queries please let me know and we can discuss them.What is it that currently occupies the majority of your professional time and effort? What do you do during a normal day?(Required)What do you want to see happening in your life that is not happening now?(Required)What skills or knowledge are you developing to move you closer to that?(Required)What are you key job/performance goals?(Required)How does what you do contribute to achieving your personal goals?(Required)If you could change some aspects of your life situation what would you choose to change?(Required)What do you consider to be your greatest accomplishments so far?(Required)What activities have meaning and heart for you?(Required)How do you find you are best motivated? Internally? Externally? Both?(Required)What do you believe to be your most important values? Do you believe you are living congruently with these values?(Required)How do you respond when you are in a really challenging situation?(Required)What three steps could you take immediately that would make the greatest difference in your current situation(s)?(Required)GOALSWhat are your top 5 goals, either short or long term, at the moment?(Required)CHALLENGESWhat are your top 5 challenges at the moment?(Required)COACHINGWhat are your major objectives or gains that you wish to achieve from our coaching?(Required)Please make a list of what you would like to gain from working with me.What can I say or do when you are “stuck” that will help you return to action?(Required)How do you want me to be as your coach?(Required)We want you to get maximum benefit from your coaching experience. This is determined by our beliefs & the rules we have about coaching & its ability to contribute to the quality of our life.What do you need to believe for coaching to have the biggest impact on your life?(Required)What, if any, expectations do you have of our coaching together?(Required)What else would you like to say?(Required)Terms and Conditions of Coaching Engagement and AgreementCoach-Client Relationship: The coach adheres to the International Coaching Federation (ICF) ethical standards and conduct. The client assumes responsibility for their well-being, decisions, choices, actions, and outcomes derived from coaching. The coach assumes no liability for coaching-related actions or outcomes. Coaching does not constitute prevention, cure, or treatment of mental disorders or medical conditions. The client maintains honesty, openness to feedback, and full participation in the program. Services, Schedule and Fees A customised coaching program mutually agreed upon delivered in-person, virtually, or over the telephone (45 minutes, 1 hour, or 1.5 hours). Fees are paid before the first session. The agreement is valid from the commencement of the first session until the conclusion of the last session.Coaching Program Selection:(Required) - Four 45-Minute Coaching Sessions – AUD $990 - Four 90-Minute Coaching Sessions – AUD $1,760 - Premium Coaching Program – AUD $5,500 - Customised Coaching Program – Investment as agreed (Please select one)Investment as agreed: AUD $(Required)Cancellation Policy: Rescheduling can be made with 48 hours’ notice. Missed session, no notification or response to coach’s emails or phone messages, session fees will be forfeited. The relationship can be terminated or discontinued at any time, with all remaining fees forfeited. Confidentiality: The coach is bound by the ICF Code of Ethics’ confidentiality principles. The coach will not disclose information without the client’s written consent, including their name. Disclosure is permitted only in cases of imminent or likely risks of danger or harm to the client or others; or illegal activity.Client Information:Name(Required) First Last Signature(Required)Date DD slash MM slash YYYY Coach Information:Coach Name First Last SignatureDate DD slash MM slash YYYY
