Coaching Inquiry Questionnaire Fill out the below Coaching Inquiry Questionnaire and "Submit" the information to us. We will review your situation and let you know if we can or cannot help you achieve your objectives. If we believe that we can work with you, we will send you a coaching proposal. Completing the questionnaire or receiving a coaching proposal does not obligate you or us to anything. We will keep your information in strict confidence. About YouName* First Last Email* Phone*Your Location (city, state, country)*OccupationWhat is the problem you want solved?Your Speaking ExperienceRate your presentation skill level from 1 to 5. (1 is low; 5 is high)12345What are your speaking strengths?What areas are you weak in?What is your educational background?What is your experience speaking in public?How often do you speak?Who and what size are your audiences?Speaking FearRate your speaking anxiety level on a scale of 0 to 10. (0 is no fear or anxiety; 10 is can't present at all)012345678910If your speaking anxiety level is 1 or 0, skip to the Results section.Describe the situations that cause your anxiety or fear.Describe what happens to you, or how you feel, when you speak in public.(e.g., knots in your stomach, sweaty palms, want to escape, etc.)Have you always had the anxiety and when did it start?If you had no fear or anxiety, what could you do or accomplish that you can't do now?ResultsWhat results, or outcomes, do you want? Explain in detail. How committed are you to making this happen?If you had the ideal coach, what would you want him to do for you and how would he do it? How valuable would this be to you personally and to your career?How You Found UsHow did you learn about us?Captcha
