Coaching Application

This questionnaire helps Eva understand your goals and where you are now, so your strategy session is as focused and valuable as possible. Take your time — there are no wrong answers.

Personal Information

Full Name *

Email Address *

Phone Number *

Date of Birth

Street Address

City

State / Province

ZIP / Postal Code

Country

Occupation

How did you hear about my coaching services, and why would you like a Strategy Session?

Self-Assessment

Rate yourself honestly on each area — 1 is low, 10 is exceptional. This helps Eva understand where to focus first.

Clarity 5

1 — Low clarity10 — Crystal clear

Energy 5

1 — Depleted10 — High energy

Courage 5

1 — Held back by fear10 — Boldly taking action

Productivity 5

1 — Struggling to focus10 — Highly effective

Influence 5

1 — Little impact on others10 — Strong positive influence

Your Story & Goals

Take your time. Write as much or as little as feels right — Eva reads every response before your session.

1. Describe your career and why you chose it.

2. What are your top 3 goals right now?

3. What are your major stressors or challenges right now?

4. What makes you feel successful and happy?

5. Describe your dream life.

6. What has prevented you from living your dream life?

7. What goal or dream have you given up on?

8. What are 3 big changes you want to make in the next 12 months?

9. What are you most proud of or excited about right now?

10. Why do you want to work with a high performance coach?

Application Received!

Thank you for completing your coaching application! Eva will review your answers and be in touch soon to schedule your strategy session.

Questions in the meantime? Email eva@evamiller.net.