For Couples SMW | Finding Bliss 4.0

Coaching Questionnaire – For Couples SMW

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Name:*

First Last

Partner Name:*

First Last

Phone:*

Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email:*

DOB:*

Astrological Sign:*

Age:*

Have you been in a long-term relationship before your current relationship?*

Yes

If yes, how many years?

Were you married?*

Yes

Do you have any children with your former relationship?*

Yes

If yes, how many and what are their ages?

What did you like about your former partner?*

What went wrong?*

How long have you been separated?*

How would you describe your current relationship?*

How long have you been together?*

Are you married?*

Do you have any children?*

If yes, how many and what are their ages?

How did you meet?*

What do like about your partner?*

What are your 3 favorite things about your partner?*

What is the hardest thing you have overcome in your relationship?*

What major transitions have you recently had in your life and relationship? ( examples: entering or approaching a new decade of life, a new job, a new role, a new residence, changes in children’s ages/stages of life, death of a loved one, birth of a child, marriage, etc.)*

How would you describe your personality?*

How would your friends and family describe your personality?*

How do you perceive yourself when you look at yourself in the mirror?*

What are your primary stressors?*

Where were you born and raised?*

Where did you grow up?*

Do you have any siblings? Are you close to your parents?*

Do you have any pets?*

How would you describe your partner’s personality?*

What does your usual week look like? (work, family, friends, wellness, spirituality, etc.)*

Where do you see yourself with your partner a year from now?*

What are some of the values you were raised with that you share with your partner?*

What is your primary motivation for engaging in this coaching process?*

What are some of the differences between what you have currently and what you want to have in life and in relationship with your partner?*

What challenges, if any, have you recognized that may be holding you back from achieving this in your life?*

Pinpoint three to five areas that you would like to address in our coaching sessions:*

What outcome would you like to receive from our coaching sessions together?*

Why is this outcome important to you?*

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