This evaluation is designed to assist you in deciding if now is the time for your extraordinary journey in coaching. Please answer the questions honestly. We realize that although some people want coaching, right now may not be the time. That's okay. If after taking this assessment, you are ready to move forward, we will be more than happy to speak with you! There are no right or wrong answers.

Your Name (required)

Your Email (required)

3—This definitely or very true of me
2—This is true of me
1—This might be true of me
0—This is not true or very not true of me

I understand the importance of compliance
I have a desire to live past my disease
I want to focus on getting healthier
I want to change and grow
I have taken efforts to change or grow within the past year
I am willing to consider new assumptions, values, and behaviors
I am not involved in counseling at present
I don't have any personal problems that could interfere with the coaching process
I am willing, if it seems wise, to get more training, do reading, and engage in other activities that could bring change and growth
I am willing to restructure my life if necessary
I understand that coaching is not mentoring, advice giving, or counseling
I am capable of thinking about the future
I have goals that aren't being reached
I am willing to work with a coach in a collaborative relationship
I am open to learning from others
I am willing and able to persist in moving toward goals
I am willing to be accountable to another person
I am open for God’s leading in the coaching process
I am or will try to be “in sync” and have good chemistry with the coach

Please describe what you would like coaching on and what you expect to change.

What Chronic Illness(es) do you have?