

Pre-Coaching Questionnaire
🌼 These 10 questions represent a starting point on your clear path to health.
🌿 There are no right or wrong answers—just an opportunity for you to reflect.
(INSTRUCTIONS: You can answer the questions on a piece of paper to keep for your own records, or you can print out the PDF and fill out the form so you can keep that.)
1 – What are your top 3 health concerns right now? How do they make you feel physically, mentally, or emotionally?
2 – How long have you been experiencing these challenges?
(Less than 6 months, 6–12 months, 1–3 years, 3+ years)
3 – On a scale of 1–10, how much do these challenges affect your daily life, energy, and overall happiness? (1 = very little, 10 = very much)
4 – What didn’t work and why do you think that was?
5 – Imagine waking up feeling vibrant and in control of your health. What does that look like for you?
6 – Why is improving your health and longevity important to you right now? What motivates you to make lasting changes?
7 – On a scale of 1–10, how ready are you to make meaningful changes for your health right now? (1 = not ready at all, 10 = very ready)
8 – What tends to hold you back?
9 – Do you think a weekly session with a health coach would help you? How?
10 – Is there anything else you’d like us to know about your health journey, your motivations, or what you’re looking for in a health coach?
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