Client Self-Assessment Name * First Name Last Name Email * Rate each area below independently from 1 to 10, where 1 is least satisfied and 10 is fully satisfied. Career Significant Other Family Friends Physical Health & Well-being Emotional Health & Well-being Physical Environment (life and/or work) Finances Spirituality/Religion Education/Personal Growth Lifestyle Balance in life Describe in more detail 1 to 5 areas you'd like to focus on in coaching: If you could create the results you're looking for in these areas, what specifically would you like to achieve in the next 90 days? What would you have to do or change to make these things happen in the next 90 days? As your coach, how can I best support you as you achieve these goals? Thank you!