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Blueprint Coaching Survey

Welcome to the Blueprint Coaching Survey.

To ensure that I understand what you are looking to achieve with your sessions, please complete the following questions. Your responses will help determine the best coaching approach to meet your specific needs and goals.

Once you complete the survey, I will review your responses and be in touch to schedule your complimentary initial Blueprint call to discuss further.

Click the button below to start.

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Question 1 of 11

What stage of your cancer journey are you currently navigating? 

(Select all that apply)
A

Recently diagnosed with cancer

B

Currently undergoing treatment

C

Just out of treatment

D

I've had a recurrence

E

Been in remission for awhile, but struggling with new normal

Question 2 of 11

What prompted you to seek coaching at this time?

(Select all that apply)
A

Emotional/psychological support

B

Relationship/family dynamics

C

Career/financial changes

D

Lifestyle adjustments

E

Navigating the new normal

F

All of the things, all at once

Question 3 of 11

Describe your current challenges related to your cancer journey.

Question 4 of 11

What are your primary goals for engaging in this coaching program?

Question 5 of 11

How familiar are you with concepts such as goal setting, mindfulness, and emotional resilience?

A

Very familiar

B

Somewhat familiar

C

Not familiar

D

Would like to learn more

Question 6 of 11

Rate your current stress level on a scale of 1-10.

A

1-3 (Low)

B

4-6 (Moderate)

C

7-9 (High)

D

10 (Extreme)

Question 7 of 11

What specific outcomes would you like to achieve by the end of this coaching program?

Question 8 of 11

Do you have any specific needs or preferences to better support you during our sessions? Examples include: Minimized screen time, voice calls only, break up sessions in shorter time slots (30 mins vs 60 mins).

Question 9 of 11

Choose a couple of options that you would like to discuss/are open to in terms of time/length of program, time commitment and flexibility. 

(Select all that apply)
A

Weekly Sessions (60 mins)

B

Bi-Weekly Sessions (60 mins)

C

Would like to discuss the option of a 1-2 Month program (Weekly or Bi-Weekly)

D

Would like to discuss the option of a longer duration program (Weekly or Bi-Weekly)

E

Would like to book the min required 3 sessions for this program (includes complimentary blueprint call) and proceed from there.

Question 10 of 11

Do you require, or would you like to discuss the option of a sliding scale fee structure? 

A

Yes. I would like to discuss this option.

B

No. I do not require a sliding scale structure.

C

I would rather speak about this in our blueprint call.

Question 11 of 11

Please share anything else you think would best support you through this coaching program.

Confirm and Submit