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Empowerment Activation Session Form

This form is designed to help us both gain clarity on your goals, challenges, and what you truly desire from our coaching partnership. Your thoughtful responses will allow us to make the most of our Empowerment Activation Session. 

Please take your time to answer these questions thoughtfully. There are no right or wrong answers, and your honesty will help us co-create the most impactful coaching experience. 

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Question 1 of 27

Your Name

SECTION 1: Let’s Ground the Conversation

Reflect on your current situation

Question 3 of 27

What do you want to focus on during our time together? (e.g., a specific goal, a recurring challenge, a desired skill) 

Question 4 of 27

What is one area of your life you’re most ready to shift or transform? 

Question 5 of 27

What have you already tried to make progress in this area? What were the results or lessons learned? 

Question 6 of 27

What’s been getting in the way? 

Question 7 of 27

What strengths, skills, or resources do you already possess that you believe will help you in this journey? 

SECTION 2: Your Vision

Clarify what you’re working toward

 

Question 9 of 27

If this area of your life changed in the next 3–6 months, what would be different? 

Question 10 of 27

What would that give you—how would you feel emotionally, mentally, or spiritually? 

Question 11 of 27

If this area were already where you want it to be, how would you show up differently? 

SECTION 3: Values & Alignment

Connect your goals to your core values

 

Question 13 of 27

What truly matters most to you right now? (Values, priorities, relationships, purpose) 
Beyond your immediate goals, what core beliefs or principles guide your life? 

Question 14 of 27

Where do you feel most out of alignment with what you want? 
In what specific situations or areas do you notice this misalignment most? 

SECTION 4: Support & Commitment

 Align your intentions with your actions

Question 16 of 27

What kind of support do you need most right now? 

Question 17 of 27

To ensure our coaching partnership is as effective and comfortable as possible, please share how you best receive feedback, insights, and challenges. (e.g., Do you prefer a direct and challenging approach, or one that's more gentle and exploratory? How do you like to be supported when you're feeling stuck?) 

Question 18 of 27

What would make coaching a powerful investment for you? 

Question 19 of 27

What would make this journey feel not just powerful — but deeply supportive and personal for you? 

SECTION 5: Success & Outcomes

Set clear markers of progress and growth

Question 21 of 27

When you look back at the end of our 6 months together, what will let you know this was successful? 

Question 22 of 27

What specific results or changes would feel most meaningful to you? 

Question 23 of 27

How will you measure or recognize your growth along the way? 

Question 24 of 27

Thank you for your openness and willingness to engage deeply with these questions. Your thoughtful insights are invaluable as we embark on this powerful journey together. 

Question 25 of 27

Having completed this form and reflected on your journey, what commitment are you making to yourself as we begin this powerful coaching partnership? 

Question 26 of 27

Client Signature:

Question 27 of 27

Date:

Confirm and Submit