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For each of the statements below, based on a scale of 1 (not true) to 5 (very true), choose the number that most closely represents how true that statement is for you.    

 

 

I am committed and motivated to grow in my career and/or personal life.

1

 2 3 4 5
I am responsible for my actions and the results I produce.

1

 2 3 4 5
I am willing to evaluate my beliefs and behaviors and change those that restrict my success.

1

 2 3 4 5
I believe I am capable of having the life and career I desire. 

1

 2 3 4 5
I believe I have unrealized potential.         

1

 2 3 4 5
I am able to be open and honest with my coach.

1

 2 3 4 5
I work well with others and welcome the contributions of others.

1

 2 3 4 5
I will take responsibility to request what I expect and desire from my coach.

1

 2 3 4 5

I see coaching as a worthwhile investment.

1

 2 3 4 5
I am someone that you can rely on to be on time for calls and appointments.

1

 2 3 4 5


   

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