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Thank you for taking the time to fill out this pre-consultation questionnaire. Your answers will help me understand your goals, challenges, and how I can best support you. This is a space for you to reflect, so feel free to be as open and detailed as you'd like.

I look forward to connecting with you soon and starting this journey together!

Warmly,
Amal Jomaa 🌿

Pre-Consultation Questionnaire

* Indicates required field

Name *

First

Last

Email *

Phone Number *

What is your age? *

1. What brings you to life coaching? Feel free to describe the challenges or areas you would like to work on. *

2. What are your primary goals? List 1–3 key things you would like to achieve during or after the coaching process. *

3. On a scale of 1–5, how committed are you to making changes? (1 = Not committed, 5 = Very committed) *

1 2 3 4 5

4. What do you think might hold you back from achieving your goals? (For example: time, motivation, self-doubt, resources, etc.) *

5. What personal strengths or skills do you bring to this process? *

6. Have you worked with a coach, therapist, or mentor before? *

Yes No

If yes, what worked well for you? *

What didn’t work well for you? *

7. What would a successful coaching experience look like for you? *

8. Do you experience any stress, anxiety, or overwhelm in your daily life? *

Yes No

If yes, how do you typically cope with it? *

9. How do you prefer to receive feedback? *

Direct and straightforward Gentle and encouraging A balance of both

10. Do you have any specific boundaries I should be aware of? *

11. What motivates or inspires you the most? *

12. Is there anything else you would like me to know before we begin? *

How did you hear about my coaching services? *

Internet Search Advertisement Friend Email Other

Submit

Looking forward to hearing from you!

Hours

M-F: 9am - 9pm

Telephone

+1 514-813-7139

Email

[email protected]

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Home
Services
About
WORKSHOPS
Contact
Book Session