New Horizon Coaching Associates

Rate your present state on a scale from 1 - 5 (1 being the lowest and 5 being the highest).

Name: *
E-mail Address: *
Best Contact Phone Number: *
Can be relied upon to be on time and prepared for all calls and appointments. *	1 2 3 4 5
This is the right time for me to receive coaching. *	1 2 3 4 5
I am fully willing to enter into a coaching relationship where I do the work of what I want most. *	1 2 3 4 5
I keep my word without struggle or sabotaging. *	1 2 3 4 5
I will try on new concepts or different ways of doing things. *	1 2 3 4 5
I will speak straight (tell the truth) to the coach. *	1 2 3 4 5
If I feel I am not getting what I want or expect from the coaching relationship, I will share this sense as soon as possible and demand that I get what I want and need from the relationship. *	1 2 3 4 5
I am willing to stop or change self-defeating behaviors which limit my success. *	1 2 3 4 5
I am someone who can share the credit for my success with the coach. *	1 2 3 4 5
I see coaching as a worthwhile investment for my life. I have adequate funds for coaching and will not regret or suffer about the fee. *	1 2 3 4 5


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