Lighthouse Coaching Client Intake Form

Before we dive into our first coaching session, I’d love to get to know you a little better. These questions aren’t just about gathering information—they’re about laying a strong foundation for our work together. The more insight I have into your goals, habits, challenges, and aspirations, the more intentional and impactful our sessions can be. Think of this form as your first powerful step toward clarity, momentum, and transformation. Your answers will help us cut through the noise, focus on what truly matters, and co-create a coaching journey that is personal, productive, and full of purpose. Take your time, be honest, and know that your responses are held with the utmost confidentiality and care. Let’s get started building the life and leadership you were made for!
Occupation & Employer
Marital Status
Preferred method of communication:
What inspired you to seek coaching at this time?
What are your top 3 goals over the next 3–6 months?
What areas would you like the most support in? (Check all that apply)
On a scale of 1–10, how would you rate your current productivity level?
Describe your current daily routine. (What’s working? What’s not?)
What are your biggest time-wasters or distractions?
What systems or tools (if any) are you currently using to stay organized?
Do you currently have an accountability partner or method? If yes, describe briefly.
Do you consider yourself a leader? Why or why not?
What leadership qualities do you admire most in others?
Have you had any formal leadership training or experience?
If YES, Please explain
What books, podcasts, or resources have most influenced your thinking recently?
How do you typically respond to challenges or setbacks?
What motivates you most when working toward a goal?
How will you know this coaching relationship has been successful?
Is there anything else you’d like to share with me before we begin?
Copyright Scott Roberts