View fullsize Dharma Coaching Intake Form Name * First Name Last Name Date MM DD YYYY Email * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### As a Coach, it's important for me to understand how you view the world in general and yourself in particular. Each person has a unique way of thinking and a unique way of interacting with those around him or her. Answer each of these questions as clearly and thoughtfully as possible, expressing the best of who you are. These are "pondering" questions designed to stimulate your thinking in a particular way that will make our work together even more productive. I suggest that you take several days to compose your responses to these questions. Thank you. For deeper insights, a couple self assessment quizzes have been linked below. Please add the results to the form fields after you take the assessments. 1. What do you want to make sure you get from the coaching relationship? (maybe write down 2 or 3 things that occur to you) 2. If you could create anything for your life over the next 5 years, and money or time were unlimited, what would you create? Include your personal and professional life. 3. What are you most passionate about? 4. What is the impact you would like to make in your community / your country / the world? 5. Write down 2-3 things that are really working well for you right now. 6. What do you do when you feel pressure, anxiety, or stress? 7. What’s missing in your life? What would make your life more fulfilling? 8. Who are the most significant people in your life? 9. What have been some of the most significant events that have shaped your life? (Describe your top 3) 10. Tell me about a time when you were operating at "peak performance", when things were going well for you, you were "on top of your game", you were pleased with what you were doing or accomplishing. What was going on? Who else was involved? How did you feel? (This is no time for modesty – share openly and deeply, like you were on top of the world!) 11. What support do you need most right now on living your Dharma? 12. Is there anything else you want me to know about you? Self Assessment Quiz Results: Quizzes are linked for you below the form fields, just scroll down and click and the link will take you there. 13. What is your Dharma archetype? 14. What is your Myers-Briggs? Thank you for taking the time to complete this information! I look forward to working with you to discover your Dharma! Self Assessment Quizzes: Myers Briggs 16 Personalities TestDharma Archetype Quiz