Initial Assessment

Full Name*

First NameLast Name
E-mail*

Confirmation Email
For the following set of questions, based on a scale of 1 to 5, please indicate if each statement is less true (1) or more true (5).

I have goals, skills, or projects I want to achieve.*

	1	2	3	4	5

1 is Less True, 5 is More True

I could use an honest, outside perspective.*

	1	2	3	4	5

1 is Less True, 5 is More True

I don’t have time to learn all I need to learn on my own. *

	1	2	3	4	5

1 is Less True, 5 is More True

I lack clarity on some choices that need to be made.*

	1	2	3	4	5

1 is Less True, 5 is More True

I need some additional support in reaching my goals.*

	1	2	3	4	5

1 is Less True, 5 is More True

I’m ready to commit some thought and time to my personal, professional, and/or spiritual development.*

	1	2	3	4	5

1 is Less True, 5 is More True

I am being asked or required to step out of my comfort zone and it is time sensitive.*

	1	2	3	4	5

1 is Less True, 5 is More True

I could use someone to help me focus, challenge me, and hold me accountable to my commitments, goals, and/or dreams.*

	1	2	3	4	5

1 is Less True, 5 is More True

I desire to accelerate results in my life and/or profession.*

	1	2	3	4	5

1 is Less True, 5 is More True

My personal, professional, and/or spiritual life is out of balance and I don’t like the consequences.*

	1	2	3	4	5

1 is Less True, 5 is More True

I could use more healthy relationships in my life.*

	1	2	3	4	5

1 is Less True, 5 is More True

I’m willing to make changes to have the life I want. *

	1	2	3	4	5

1 is Less True, 5 is More True

Add up your scores above and based on your results... you are...

60-48: Definitely ready for coaching.

47-36: Ready for coaching.

35-24: Ready, but terms of coaching agreement must be adhered to.

24-12: It may not be the right time for you to pursue coaching.
Please briefly describe why you are interested in coaching and what you hope to achieve? Please be as specific as you can.*
Anything else you would like to add?
How did you learn about Crystal Renaud Day?*
Upon completion of the assessment, please use the submit button below to send your assessment to Crystal Renaud Day for review. Upon review, she will email you with follow-up. In the meantime, you can schedule a free 30-minute consultation.
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