Lead Capture Form

Luv Life Coaching Readiness Questionnaire

Is coaching an appropriate next step?

Name required

Please contact me regarding eligibility. Email: required

Have you had a professional coach before (for life or business)? required

Yes No

In general, what levels of trust characterize your relationship? required

We equally trust very well in both directions

I trust more than I am trusted

I trust less than I am trusted

Trust is an issue in our relationship

Putting resources (time, effort, money) towards our future success as a couple is: required

something we frequently do

something we have not done but are committed to doing

something we are interested in, if the effort is manageable with our schedules

How committed are we to fully participating in the coaching program? required

Me - Very highly committed

Me - Interested but unsure of commitment level

Partner - Very highly committed

Partner - Interested but unsure of commitment level

Which of the following relationship competencies do you think you are each best at? (Number 1 - 5, 1 being best):

Initiating a difficult / conflictual conversation required

Handing our financial decisions wisely required

Connecting regularly at an emotional level required

Showing love the way my partner needs it required

Acknowledging and celebrating my partner required

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