Coaching Questionnaire

Please fill out the form below

1. Your Information

First Name

Last Name

Email^*

Phone^*

Address^*

2. Your Child(ren) Name and Age

Your Child(ren) Name^*

Your Child(ren) Age^*

3. Your Well-Being

How are you today? Share a glimpse of your life beyond parenting.^*

Any self-care practices you prioritize?^*

Are you happy? Why or why not?^*

4. Parenting Challenges

What hurdles are you currently facing as a parent?^*

How do you manage stress related to parenting?^*

5. Family Dynamics

Describe your family structure (nuclear, blended, extended).^*

How do you foster open communication with your children?^*

6. Values and Modeling

What values do you want to instill in your children?^*

How do you embody those values in your own life?^*

7. Child’s Uniqueness

Tell me about your child’s personality and interests.^*

What strengths or needs do they have?^*

8. Parent-Child Bond

How do you connect with your child daily?^*

Share any special moments or activities.^*

9. Emotional Navigation

How do you handle your child’s emotions (tantrums, meltdowns)?^*

How do you regulate your own emotions?^*

10. Setting Boundaries

What discipline strategies do you use?^*

How do you establish and enforce boundaries?^*

11. Support Network

Who’s part of your parenting support system?^*

How do they lift you up?^*

12. Parenting Goals

What specific developmental goals do you have for your child?^*

How do you measure progress?^*

13. Parenting Goals

How do you balance parenting with other aspects of life?^*

Any adjustments you’d like to make?^*

14. Self-Compassion

How do you practice self-kindness during challenging moments?^*

What’s your inner dialogue like?^*

15. Parenting Harmony

How do you collaborate with your partner or co-parent on decisions?^*

Any communication improvements needed?^*

16. Learning Resources

Have you explored parenting books or workshops? Which ones?^*

Any additional resources you seek?^*

17. Hopes and Dreams

What positive changes do you envision for your family? Let’s create that roadmap together!^*

18. Share Your Thoughts

Feel free to share your thoughts, and we’ll create a personalized coaching plan that addresses your family’s unique needs! 🚀