Coaching intake Form Contact Information Name * First Name Last Name Company * Department * Title * Best number to contact you * (###) ### #### Email * Questionnaire Have you ever worked with an executive coach before? If yes, what was your experience like? * What are you looking for most in an executive coach? * What are 3 development goals you wish to achieve from working with a coach? * What is your biggest challenge as a leader right now? * What are your top 5 strengths from the Gallup CliftonStrengths assessment? * What would success look like for you at the end of our time together? * Expectations and Confidentiality Thank you for your time in helping us understand what is most important to you. If this is your first time working with an executive coach there is some information for you to understand going into the coaching relationship. Please copy and paste the following link into your browser to download and view the information in this document: https://www.dropbox.com/scl/fi/charnas2vj72l9hbixzq1/Executive-Coaching-Expectations-for-Tower-Hill.pdf?rlkey=h0u7sq5rlb6lhyn9g2ov1u7q1&dl=0 After doing so, please check the box below to acknowledge that you have received, reviewed, and understood the information in the aforementioned document. Acknowledgment * I have reviewed the information above about coaching expectations and the confidentiality of the coaching partnership. I understand what is being asked of me as a Coachee and agree to fulfill the expectations listed. Your responses to this form will ONLY be shared with necessary members of The Kelly Merbler Company. Tower Hill will not receive your responses. Thank you!
