Confidential Leadership Client Intake Form

CONGRATULATIONS ON CHOOSING TO ACCELERATE YOUR SUCCESS!

Coaching is globally recognized as an intensive and efficient strategy for individualizing improvement in a number of key areas. The International Coach Federation defines coaching as partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.

Name
First Last
Company Name*
Email*
Phone Number
Cell Phone
Website Address
Age*
Mailing Address
Street Address Address Line 2 City State ZIP Code
Please take 15 minutes to reflect on the answers and provide Brenda with some important information. Use as much room as you like to answer the questions. The more information the better.
What are you hoping to achieve through coaching?*
Describe your current reputation at work:*
What would you like to change about your current reputation?*
What is the primary outcome you are responsible for at work?*
Do you feel successful in your role? Why/Why not?*
What is your greatest professional “pain” at work?*
Have you done any formal leadership development in the past (workshops, programs, etc)?*
How well do you manage your time? Elaborate about how things are from a time-management perspective at work.*
About your team
How many direct reports do you have?*
How functional and productive are your team meetings?*
What methods do you use to engage your team currently?*
Are you a business book/professional development reader? If so which titles in the last year or so and your opinion of the books?*
Which (if any) assessments have you taken already?*
- The DiSC Test (within last 3 years)
- Emergenetics
- Emotional Intelligence Testing
- The Birkman Method
- The Enneagram Profile
- Others
Other Assessments Taken
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CONGRATULATIONS ON CHOOSING TO ACCELERATE YOUR SUCCESS!

Please take 15 minutes to reflect on the answers and provide Brenda with some important information. Use as much room as you like to answer the questions. The more information the better.

About your team

We curate the thought leadership of others on our social media. On the next page, you can follow us on your favorite social media channels.

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The Highly Engaged Leader

Leader burnout is reaching unprecedented levels. While time off can help, what leaders truly need are enhanced tools and skills to effectively navigate the overwhelming stress and pressure of modern leadership.