Current and Desired States Form

Please take a little time to contemplate your answers on the following questions. This gives us a snapshot of where you are in the coaching process in each of these areas. There are nine sections below, each representing a section of the Duke Wheel of Health which defines true health based on these nine factors. To see an image of the Wheel, click HERE or to read a more detailed description of the nine segments, click HERE. Please complete and submit this form at least 48 hours prior to our session.


After you submit this form, a copy of what you submitted will come onto the screen. Click HERE to return to the Coaching Paperwork page.