Your Name):

Address:

City:

State:

Zipcode:

Cell:

Email:

Best Time to Reach:


Occupation/Ministry/Role:

Currently, what is going well for you?

Currently, what is not going well for you?

What do you wish would happen?

What are you afraid will happen?


In regard to your life purpose, which of these statements most closely describes you?

Yes
Understanding what God wants of you, but feeling guilty for not focusing on it? Yes
Doing what God wants of you, but stressed because your life is out of balance? Yes
Doing what God wants of you and experiencing joy and success? Yes

Wrap Up

What specifically do you think I will be able to do for you as a Life Purpose Coach™?