Post Adoption Coaching and Consulting - questionform

The purpose of this questionnaire is to provide some information to help create a foundation for the coaching relationship that will best satisfy your needs. There are no right or wrong answers. Your answers will convey what is important and meaningful to you.

Check All That Apply:

Adoptee

Adoptive Parent

Birth Parent

Adoption Professional

Other

Name:
Home Telephone:
Work Telephone:
Fax Number:
Email:
Address:
Mailing Address (if different):
Occupation:
Age:	select 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98

1. What are your concerns, issues, questions or problems that you want to work on in coaching?


2. What result do you want to get from the coaching?


3. How do you want your coach to be with you?


4. What should the adoption coach know or understand about you and your situation to be most helpful with your concerns?


5. What could you do differently now to help make your problem (issue or concern) improve?


6. What should your coach do and say to help you move forward and achieve your purpose?


7. Describe what a successful and satisfying coaching outcome would look like?


8. Describe the outstanding frustrations and stressors in your life.


9. Describe major sources of satisfaction, support and strength in your life.