Life Coaching Tools What are your hurdles? (Please rate your hurdles on a scale of 0 to 5, 0 being the lowest impact and 5 being the greatest impact and why)
1) No money
0 1 2 3 4 5
____________________________________________
2) No education
0 1 2 3 4 5
____________________________________________
3) Family/friends will disapprove
0 1 2 3 4 5
____________________________________________
4) Need for perfection
0 1 2 3 4 5
____________________________________________
5) No time
0 1 2 3 4 5
____________________________________________
6) Current Location of home or business
0 1 2 3 4 5
____________________________________________
7) Self doubt/lack of self-confidence
0 1 2 3 4 5
____________________________________________
8) Lack of focus
0 1 2 3 4 5
____________________________________________
9) Failure to follow0 1 2 3 4 5 through/self-sabotaging
____________________________________________
10) Lack of motivation
0 1 2 3 4 5
____________________________________________
11) Previous attempts have failed
0 1 2 3 4 5
____________________________________________
12) Don’t really know 0 1 2 3 4 5 what I want or need
____________________________________________
13) Fearful (of what)
0 1 2 3 4 5
____________________________________________
14) My Age
0 1 2 3 4 5
____________________________________________
15) Socio-economic or ethnicity
0 1 2 3 4 5
____________________________________________
Additional comments: ________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Created by Janice Wheeler, CLC 02/15/10
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