BUSINESS COACHING ASSESSMENT

Your Name (required)

Date (required)

Your Email (required)

Please answer these questions honestly and succinctly.
Feel free to leave out any questions you are not comfortable answering. This information is confidential.

YOUR BUSINESS
Explain your business in a sentence or two:

Before you went into business, what did you do?

Is the business your sole source of income?
YesNo

If no, how else do you earn income?

On average, in a week, how many hours do you work in relation to your business?

If the business is not your sole source of income, how many hours are split between working on your business and earning other income?

What are the three main pressures on your industry right now?
1.

2.

3.

At what stage is your business? Check one and describe in a short sentence:
Not yet up and runningEarly stagesStarting to succeedWell-established

At what stage are you as a business owner? Check one and describe in a short sentence:
New business owner1st year2nd or 3rd year3rd to 5th yearHighly experienced

Describe your three biggest wins in business (this one or previously):
1.

2.

3.

Describe your three biggest challenges in business (this one or previously):
1.

2.

3.

Describe your three biggest strengths in business (this one or previously):
1.

2.

3.

What are three things that would make your role easier to fulfill?
1.

2.

3.

What is your vision for your business?

What are your goals for your business? (First thoughts if you have not devised these yet)
3 Months

1 year

5 years

10 years

Do you have a business plan? YesNo

RATINGS
Rate yourself out of 10 in terms of the following in relation to your business.
(1 being “nowhere near it” and 10 “completely on top of it”). Write N/A if anything doesn’t apply.

Clear business vision
/10

Profitability
/10

Cash flow
/10

Good leadership
/10

Sound management systems
/10

Sufficient resources (physical, IT, financial)
/10

Positive business culture/working environment
/10

Solid distribution systems
/10

Solid marketing plan
/10

Solid sales plan
/10

Desire to continue in the business
/10

Any additional information you think might be relevant about your business?

PERSONAL INFORMATION
What are your three top personal values?
1.

2.

3.

How well do these values align with your business?
(Define each value as a percentage)
1.

2.

3.

Rate yourself in terms of the impact your business has on your personal life (1 means “completely
dissatisfied,” 10 means “totally happy”.) Write N/A if not applicable.

Significant Relationships
/10

Family Life
/10

Social Life
/10

Community Life
/10

Health & Fitness
/10

Level of Personal Satisfaction
/10

Stress Levels
/10

Sense of Balance
/10

List three things you would most like to get out of coaching:
1.

2.

3.

What other information would you like your coach to know at this time?