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Client Baseline Info:

1.I want to improve or expand/extend use of the following skills, talents, strengths, capabilities:

A. 

B. 

C. 

2.I want to clarify and identify the best professional path for more preparation for me to diversify my career in the following ways:

A. 

B. 

C. 

3.I want to resolve or rectify the following problems or challenges:

A. 

B. 

C. 

4.Within the upcoming 90-120 days, I want to eliminate the following energy drainers, life inconveniences, or tolerations I’ve been putting up with in my life:

A. 

B. 

C. 

5.I want to accomplish the following measurable or observable results: (and have stated each in such a way we will both be able to track outcomes together in this process.)

A. 

B. 

C. 

6.At this point, I think that I’d like to make these fundamental changes or shifts in mind-set, belief, or point of view:

A. 

B. 

C. 

7.Clarifications or verifications I believe you may be able to help provide reside in the area(s) of: (transferable skill-sets and capabilities may apply here for one of these)

A. 

B. 

C. 

8.Additionally, what I will most value from you, as my career consultant, includes:

A. 

B. 

C. 

9.Have you taken any of the following assessments or tools?

Insights: 

DISC: 

Birkman: 

Hogan: 

MBTI or Myers/Briggs: 

Kolbe: 

StrengthsFinder: 

VIA Strengths: 

Colors: 

Other: 

10.Any additional information you would like for me to know:

A. 

B. 

C. 

11.Questions you might have for me as your career consultant:

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B. 

C. 

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