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

Self-Assessment

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 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

Person A
Person B
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