Client Questionnaire

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Hi! I am so glad we will be working together! I am here to support you, but I would like to get to know more about you. Please complete this form, and let me know if you have any questions, or would prefer to complete this during a meeting. I am totally flexible!

Please answer each question as accurately as possible.
The information you give is confidential and voluntary and should come from your previous educational and/or work experiences.

Date

First Name

Last Name

Phone

Address

Social Media Links

Company employed by

Job title

University degrees/certifications

General info about you!

What is your current situation?

Education

Looking to study

Currently studying

Other

Employment

Currently employed

Early in career: First job

Employed looking for new job

Employed looking to change careers

Unemployed looking for a job with previous work experience

Unemployed looking to change careers

Previous Coaching/Mentoring

Please give detailed answers and examples from your past educational, training and/or work experiences.

Have you had any mentoring or coaching in the past?

If you answered yes, what worked, what didn’t work?

What does coaching/mentoring mean to you?

List 3-4 priorities that you would like to achieve during our work together.

Communication

What is your overall preferred way of communicating? (Re Feedback, Instructions, Work performance)

In person

Text

Slack

Other

Work Environment

What is your optimal work environment?

Time management and planning whilst working or studying

Pease let me know about the following skills:

Priorities

Deadlines

Last minute changes or cancellations

Switching tasks/priorities at the last minute

Time management

Uncertainty, knowing what’s coming up

Problem solving

Trouble shooting

Note taking

Organization of ideas or resources

Thinking outside of the box

Assertiveness/self-advocating

Asking for assistance

Taking breaks

Attendance and punctuality

Time management and planning whilst working or studying

How do you find working on a team?

Tell me about your experience with collaboration.

Tell me about a great experience with colleagues or a manager whom you have worked with in the past.

Thank you for submitting!

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