New Client Form

Previous Experience of Coaching, Counselling or Therapy. (please state what the therapy/coaching was for)

Favourite Development Books Read or CD’s listened to: (if you can remember please also state the author)

Year
Book or Tape Name & Author
What you got out of it & liked about it
What you did not like about it

Four or more events in your life you are proud of:

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2
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6

Four or more significant experiences that you believe have made you who are you are today:

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6

Four or more achievements/outcomes that you would like to create over the term of this project:

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2
3
4
5

What is the hardest thing you have ever had to overcome?

What are your primary stressors?

What types of approaches discourage you or take away your motivation?

Any information you think would add value to your Coaching Program: