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Coaching Intake · Pro

Executive Leadership Coaching Intake & Goal Assessment

Collect client backgrounds, leadership self-assessments, and coaching goals with this professional executive coaching intake form template.

Use This Template Free Preview

Terra theme

formbuilder.ai/f/executive-leadership-coaching-new-client-intake-goal-assessment-form

Executive Leadership Coaching New Client Intake & Goal Assessment Form

Full Name

· · ·

Email Address

· · ·

Phone Number

· · ·

Submit

The Executive Leadership Coaching New Client Intake & Goal Assessment Form is designed to help executive coaches and leadership development professionals gather the critical information needed to personalize each coaching engagement. From contact details and professional background to leadership competency self-assessments and development priorities, this form ensures you have everything you need before the first session begins.

This template is ideal for independent executive coaches, corporate leadership development teams, and coaching consultancies working with senior leaders, directors, and C-suite professionals. It captures key data such as years in leadership, number of direct reports, and self-rated confidence levels across core competencies, enabling a truly tailored coaching experience from day one.

By standardizing your intake process, you save time, reduce back-and-forth communication, and demonstrate professionalism to high-level clients. Use this form to align on expectations, set measurable goals, and build a strong foundation for a transformative coaching relationship.

4 Pages

27 Questions

~9min To complete

Free No credit card needed

Field types Long Text ×5 Dropdown ×3 Single Choice ×3 Short Text ×2 Full Name Email Phone Address number Website URL Multiple Choice ranking Likert Scale Yes / No Scale Rating File Upload termsandconditions Signature

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 Personal & Professional Information 10 questions

Personal & Professional Information

Please provide your contact details and professional background so we can tailor your coaching experience.

1 Full Name * Full Name

2 Email Address * Email

3 Phone Number * Phone

4 Mailing Address Address

5 Current Job Title * Short Text

6 Organization / Company Name * Short Text

7 Industry * Dropdown

8 Years in Current Leadership Role * Dropdown

9 Number of Direct Reports * number

10 LinkedIn Profile URL Website URL

Page 2 Leadership Background & Self-Assessment 4 questions

Leadership Background & Self-Assessment

Help us understand your leadership journey, strengths, and areas where you'd like to grow.

1 Briefly describe your leadership journey and key career milestones that brought you to your current role. * Long Text

2 Which leadership competencies do you consider your greatest strengths? (Select all that apply) * Multiple Choice

3 Rank the following development areas from most to least important for your growth: * ranking

4 Rate your current confidence level in each area: * Likert Scale

Page 3 Coaching Goals & Expectations 8 questions

Coaching Goals & Expectations

Define what success looks like for you in this coaching engagement.

1 What are your top 2–3 goals you want to achieve through executive coaching? * Long Text

2 What specific challenges or obstacles are you currently facing as a leader? * Long Text

3 What is your preferred coaching engagement timeline? * Dropdown

4 Preferred session format * Single Choice

5 Preferred session frequency * Single Choice

6 Have you worked with an executive coach before? * Yes / No

7 If yes, what worked well and what would you like to be different this time? Long Text

8 How did you hear about our coaching services? Single Choice

Page 4 Commitment & Agreement 5 questions

Commitment & Agreement

Please review and acknowledge the following to finalize your intake.

1 On a scale of 1–10, how committed are you to investing time and energy into your coaching journey? * Scale Rating

2 Is there anything else you'd like your coach to know before your first session? Long Text

3 Upload your current resume or leadership bio (optional) File Upload

4 I acknowledge that coaching sessions are confidential, and I agree to the cancellation policy and coaching engagement terms outlined in the welcome packet. * termsandconditions

5 Client Signature * Signature

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.