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Cancer Coaching Questionnaire

Your voice, your pace. Share only what feels right.

Thank you for choosing to embark on this journey of support, resilience, and empowerment. This questionnaire helps us understand your needs as you navigate life with cancer. Coaching is not medical treatment; it’s a supportive partnership focused on your goals and wellbeing.

Confidentiality: Your responses are confidential, except in situations where safety is at risk.

Demographic Information
















Health Information

In preparation for working with me, please take some time to reflect and answer these questions before we meet. When it comes to your goals, think BIG and don’t worry about how you will get there. When it comes to challenges be honest with yourself.