Your Full Name & Contact Information:

Current Role/Occupation: What is your primary profession or role?

Industry: What industry do you work in?

How long have you been in this role/industry?

What are your primary responsibilities related to communication? (e.g., leading meetings, client presentations, team updates, public speaking engagements, sales pitches, networking)

Describe your general comfort level with public speaking/presenting: (e.g., Very confident, comfortable, somewhat nervous, extremely anxious). Provide a rating from 1-10 (1 = extremely anxious, 10 = completely at ease).

When was the last time you had to speak publicly (formally or informally)? What was the situation? How did it go?

What types of speaking engagements do you typically encounter or anticipate? (e.g., small team meetings, large conference presentations, virtual presentations, one-on-one client meetings, networking events, social gatherings, interviews, panel discussions).

What are your most common audiences? (e.g., colleagues, direct reports, senior leadership, clients, external stakeholders, general public).

Recall a positive public speaking/communication experience: What made it positive? What felt good or successful?

Recall a challenging or negative public speaking/communication experience: What happened? What made it difficult? How did you feel before, during, and after?

Describe the physical sensations you experience when nervous about speaking: (e.g., racing heart, shaky voice, sweating, dry mouth, trembling hands, blushing, shortness of breath, stomach upset).

Describe the mental/emotional challenges you face: (e.g., "going blank," fear of judgment, imposter syndrome, self-doubt, perfectionism, difficulty organizing thoughts, forgetting content).

Are there specific situations or types of audiences that trigger your anxiety more than others?

What specific areas of public speaking or confidence do you feel are your weakest? (e.g., vocal projection, body language, storytelling, Q&A handling, impromptu speaking, opening/closing, engaging the audience, presentation design).

What do you believe is currently holding you back from achieving your communication goals?

What are your top 2-3 primary goals for this coaching program? (Be as specific as possible).

• Example 1 (Too general): "I want to be more confident."
• Example 1 (Better): "I want to deliver a 20-minute client pitch without using notes and effectively handle Q&A, feeling calm and confident."
• Example 2 (Too general): "I want to improve my speaking."
• Example 2 (Better): "I want to lead team meetings confidently, ensuring everyone participates and decisions are made efficiently, without rambling or losing my train of thought."

What would "success" look and feel like for you at the end of our coaching journey? Be descriptive.

Do you have any upcoming specific speaking engagements or opportunities that you want to prepare for? If so, please provide details (date, audience, topic).

How would improved public speaking and confidence impact your professional life? Your personal life?

What is your long-term vision for your communication skills? Where do you see yourself in 1, 3, or 5 years as a communicator?

How do you typically learn new skills most effectively? (e.g., hands-on practice, theoretical understanding, visual aids, listening, reading, trial and error, direct feedback).

What kind of feedback do you find most helpful? (e.g., direct & constructive, gentle & encouraging, video analysis, written notes).

Are there any specific topics or areas you are particularly eager to focus on immediately?

Is there anything else you'd like your coach to know about you or your communication journey?