Coaching Self-Assessment

Are you considering participating in Financial Coaching? Wondering if you are ready? Complete the self-assessment below. If you choose to have us contact you, we will reach out as soon as possible.

Name *

First

Last

Email *

Phone *

How do you prefer to be contacted? *

Would you like someone from Moneytalk to contact you? *

How ready are you to set challenging goals for yourself and your family? *

1 = I don't like goals, they don't work for me.
2 = Goals can be helpful, but have a hard time sticking to them.
3 = I am ready. Bring it on.

How ready and able are you to make changes to reach your new goals? *

1 = Doubt it, I have already tried everything
2 = Not sure it will make a difference, but I am willing to try
3 = Let's do this

Do you believe a coach can expedite your progress? *

1 = No
2 = Maybe
3 = Yes

Is coaching something you want to participate in? *

1 = No, I was told to do this
2 = Not really, but willing to give it a try
3 = Yes

Are you willing to try doing things a new way? *

1 = No, I have already tried everything
2 = Kind of, I am uncomfortable making changes and trying new things
3 = Yes, I can't keep going this way

I can commit to meeting with my coach at least once a month *

1 = I don't know, my schedule is not consistent and the kids have lots going on
2 = My schedule is very busy, but I will try
3 = Yes, I will find a way to make it work

Are you active in a Christian Church? *

1= I attend a non-christian church
1 = I do not attend church
2 = I usually or frequently attend a Christian church, but am not active
3 = I regularly attend a Christian church and participate in at least one activity/group outside of worship service

I am willing to share personal and financial information *

1 = I am uncomfortable sharing personal information
2 = I am willing to share the information I need you need to know
3 = The more information you have, the more my coach can help

I am willing to attend workshops in addition to coaching sessions

1 = No, I don't want to be seen or don't have enough time for that
2 = I will try to take advantage of the workshops
3 = Yes, I will do whatever it takes to get out of this situation

I agree to complete the action items assigned during coaching sessions *

1 = I will only complete the actions items I have time for and feel will be
2 = I will try to complete action items as I have time available
3 = I will do my best to complete the action items each month

I am willing to stop or change self-defeating behaviors *

1 = No, it is too hard to quit, these habits are my way of managing the stress
2 = No promises, but I will try
3 = Yes, I will work hard to stop or change my behaviors that are hindering my progress

I will communicate with my coach between sessions as needed *

1 = All questions and responses need to happen during our coaching sessions
2 = I would rather hold my questions until our next session, but I will respond to my coach's emails
3 = Yes, I will ask questions as soon as I have them and respond to emails from my coach as quickly as possible

I will pay the agreed upon monthly amount *

1 = Money is too tight and other expenses have a higher priority, so I cannot promise anything
2 = With my coach's help, I will try my best to make the monthly payments
3 = I will make paying for coaching a priority over non-essential expenses

If making a pledge, do you want it reported? *

1 = No
2 = N/A
3 = Yes

How did you learn about our Coaching services? *

Name