Questionnaire Form

*Please type responses to all questions and e-mail back to codyrdover@gmail.com. All Information is Private & Confidential.

Name*
First
Email*
Phone Number*
Goals
What are the 3 BIGGEST goals you want to achieve over the next 12 months?*
Explain to me your vision ONE year from now. BE SPECIFIC as possible? (All Areas) Money, relationships, Business, spirituality etc.*
PERSONAL HISTORY
What would you say have been your three greatest accomplishments in your life to date?*
What is the hardest thing you have ever had to overcome?*
Hows your relationship with yourself?*
Whose love did you crave love from most, your mother or father? And who did you have to be for that person?*

YOUR LIFE
Who are the key people in your life right now?*
How much of your life do you spend, trying to feel in control?*
On a scale of 1 – 10, 10 = HIGH, provide a number that represents your current level/degree of stress:*
What are your primary stressors? Be Specific*
Tell me about your pattern when you get stressed or overwhelmed? Give example.*

COACHING YOU
What do you hope to address with your coaching & accountability sessions?*
What would you expect or like your Coach to do if you get behind on your goals?*
Do you get motivated by someone telling you what to do or motivated by inspiration?*
Explain to me your WHY for doing this?*
If you could do anything for the rest of your life, what would you be doing?*
Life Visions
How important is it for you to Focus & grow right now?*
If you could be in the perfect position 6 months from now, what would that look and feel like?*
What would you like to contribute to the world?*
What is a dream or goal you want but have heaps of resistance for?*
What’s your ultimate relationship vision?*
On a scale of 1 to 10 (10= HIGH), rate the quality of your life today:*