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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! 🚀
Submit
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