FLTIC Business Needs Evaluation Form

From Lost to In Control Business Evaluation
Instructions for completing this form
1. Create some time to focus on completing this form. Please fill out the form to the best of your ability. If you are unsure of anything or of what answer to give you can check this with Breda on your first call/meeting.
2. You are about to clarify and set your outcome for completing this program and figure out what is going on right now
3. Your Primary goals may change in time – this is fine – do not spend your time trying to fix what is not perfect with what you have written – accept that whatever you have done is perfect RIGHT NOW.
4. Email this to your Breda once you finish by simply hitting the submit button at the bottom of this form.
Personal Informaiton
Full Name *

First Name Last Name
Gender *
Birth Date *

Month Day Year
E-mail *
Phone Number *

Area Code Phone Number
SKYPE ID
Breda is b-stacky on skype

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

You and Your Business
What is your main goal for enrolling in and completing this coaching program? *
What is the number one reason you want to achieve this goal? *
How will you achieve this goal over the next 8 months? *
What is currently working in your business? *
What is not working? *
Why is this a problem in your business right now? *
Why is it important to get this problem solved? *
Money
How much income has your business generated in the past year? *
How much would you like to generate in the next 12 months? *
What is the minimum amount you need to generate each month just to cover overheads? [both business and personal] *
What do you currently have to sell in your business? *
How are you getting clients and selling right now? *
How much time do you dedicate to selling on a daily basis? *
What do you think has stopped you making the money you want up until now? *
Thinking about how your business is set up, What do you feel is missing from your business structure in order to allow you to make more money? *
How would you describe your relationship with money? *
How do you treat money? *
You
Since you are the key to your business it is also important to have a look at you in your business.
What motivates or excites you in relation to your business? *
Why is it important to you to have your own business? *
How would you feel if this did not work out? *
What are you committing to change in order to have the results you want? *
What will these results get for you or allow you to do? *
What resources do you have now and what do you need to get in order to achieve your desired results? *
About Your Goals
Your Business.. looking back
What are your 3 biggest accomplishments?
Accomplishment#1 *
Accomplishment#2 *
Accomplishment#3 *
What pushed you to achieve these 3 goals that you think might be missing from you and your business now? *
What are the goals you have made but did not achieve? *
What has REALLY stopped you from achieving these goals? *
What help do you think you need to move past this? *
Your Business, looking ahead...
What are your top 5 business goals for the next 12 months? *
What is your long term vision for your business and personal goals? *
What is the most important goal to hit over the next 3 months? *
What are the 3 biggest obstacles & challenges you want to overcome to get your goals to the next level? – make #1 the most pressing issue
Challenge#1 *
Challenge#2 *
Challenge#3 *
What are you committing to RIGHT NOW to face these challenges head on? *
About your coaching..
What are the top 5 things (or criteria) you want in a Coach?
CoachCriteria#1
CoachCriteria#2
CoachCriteria#3
CoachCriteria#4
CoachCriteria#5
What are the top 3 ways your Coach can support you through the coaching program?
CoachSupport#1
CoachSupport#2
CoachSupport#3
Anything else you would like to add?
Should be Empty:

From Lost to In Control Business Evaluation

Instructions for completing this form

Personal Informaiton

You and Your Business

Money

You

About Your Goals

Your Business, looking ahead...

About your coaching..

What are the top 5 things (or criteria) you want in a Coach?

What are the top 3 ways your Coach can support you through the coaching program?