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Thank you for your interest in a coaching session with Andrea Richards Scott, Certified Professional Coach. The information you provide will not be shared with a third-party.
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| First Name
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| Last Name
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| E-mail
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| Street Address
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| City
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| State
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| Zipcode
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| Birthday
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| What are three positive adjectives that describe your best qualities?
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| What are you most proud of in your life?
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| What was the hardest thing you’ve had to overcome so far in your life? And what did you learn from the experience?
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| Success means different things to different people. What does success mean to you?
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| If money were no object, and you could do anything you wanted, what would that be?
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| When dealing with a project, are you better at Starting, Improving, Completing or Stopping
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| For what has your life been preparing you?
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| On a scale of 0 to 10, with zero being AWFUL and 10 being SUPERB, how satisfied are you with your professional life?
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| On a scale of 0 to 10, with zero being AWFUL and 10 being SUPERB, how satisfied are you with your personal life?
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| On a scale from 1-10 how satisfied are you with the balance you have achieved between your Life and your Livelihood?
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| On a scale from 1-10 how responsible are you for the way your life is today?
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| If you had a magic wand and could change anything in your life, what would that be and why?
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| Complete this statement: I feel that my purpose in life is…
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| What would you like to accomplish in your initial session?
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