Discovery Call Intake Form | Catalyst Wellness Coaching LLC

Couples Discovery Call Questionaire

Person A

Person B

Why are you reaching out to a Health Coach? What specific health, wellness, and lifestyle changes would you like to make? Please list them below and rank them on a scale 1-10, how important is it to you to make each one of these changes?

1-Not Very important 10- Non-Negotiable.

Person A

Person B

How would your life together be different if you were to achieve these health changes?

What have been your barriers to creating health changes together?

How do you feel a health coach will help you achieve your goals? What can I provide that would be most helpful?

Please list 3 things you've tried in the last 2 years that have improved your health

Please list 3 things that you've tried that have not worked

Have either of you taken any of the follwing personality inventories?

Gretchen Rubin 4 Tendencies

DISC

Enneogram

Strengths Finder

If so what were the results?

Self-Assessment

Tell me some of the things you each like to do

Name one way you can support your partner and this process

Name one thing I as your coach can do to assist

Any pre-existing medical or mental health conditions I should be aware of for either of you?

Anything else I should be aware of?

On a scale of 1-5 please rate whether you agree or disagree with the following statements:

1= Strongly disagree 2= Disagree 3= Unsure 4= Agree 5= Strongly Agree

I am open-minded about learning new ways of eating, moving, and living

I can commit to changes that feel uncomfortable, unusual, or unconventional

I will keep my word to my coach and myself

I understand health coaching is an investment in myself for positive long-term change

Couples Discovery Call Questionaire

Person A

Person B

Person A

Person B

Person A

Person B

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