MINETUM CLIENT INTAKE FORM

(Pre-Coaching Questionnaire)

Thank you for your submission!

Full Name

Address

Phone

Date of birth

LinkedIn URL

Academic Background

Occupation

How did you find me?

Tell me about yourself

What do you want to achieve by working with a coach?

Tell me about your current situation and your biggest challenges

What have you already done so far to work on this?

What are your top 3 goals for the next 3–6 months?

What are your biggest desires for your next step?

Anything else you would like me to know?