ADHD Coaching Questionnaire: Is It Right For Me?

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Is ADHD Coaching Right for
Me?

Curious about working with an ADHD Coach?

Complete and submit this simple questionnaire and find out if ADHD Coaching is for you.

Respond with I Agree to all that apply to you.

I believe my challenges are related to ADHD/ADD. *

I agree

I need help setting goals. *

I agree

I have trouble focusing on what is really important to me. *

I agree

I find it hard to trust myself. *

I agree

I want something to change for the better in my life. *

I agree

I have trouble seeing positive change in my life. *

I agree

I want to understand how my ADHD affects me, specifically. *

I agree

I want to work with a Coach who understands the challenges specific to ADHD. *

I agree

I want to gain an understanding of my personal obstacles. *

I agree

I want to work towards overcoming my personal obstacles. *

I agree

I want to understand my limiting beliefs (the thoughts, feelings and behaviours that hold me back). *

I agree

I am overwhelmed by work/life stresses. *

I agree

* Indicates required field

I have been diagnosed with ADHD/ADD. *

Yes No

My primary reason for wanting to work with an ADHD Coach is: *

What is your age? *

Less than 13 13-18 19-25 26-35 36-50 Over 50 Prefer not to say

Name *

First

Last

Email *

I agree to receiving marketing and promotional materials *

Submit

Empower Your Child

"If a child can't learn the way we teach, then we should teach the way they learn." ~ Ignacio Estrada
Psychoeducational and Attentional Assessments level the playing field for your child enabling teachers to teach in the way your child learns.

Empower Yourself

Talking about our challenges can feel awkward and scary.
Our compassionate team of coaches, counsellors and therapists will help you find your strengths and resources to help you live your best life.

Contact Us:

* Indicates required field

Name *

First

Last

Email *

Comment *

Submit

BURLINGTON

3228 South Service Road, Suite 101 L7N 3H8

WINDSOR

552 Pitt Street West, Suite 103 N9A 5M2

Hours

M-F: 9:30 am - 4:30 pm
Other hours possible upon request

Telephone

1-888-239-1483

Email

[email protected]

Respond with I Agree to all that apply to you.

Empower Your Child

Empower Yourself

Contact Us:

​BURLINGTON3228 South Service Road, Suite 101 L7N 3H8WINDSOR​552 Pitt Street West, Suite 103 N9A 5M2

Hours

Telephone

Email

BURLINGTON

3228 South Service Road, Suite 101 L7N 3H8

WINDSOR

552 Pitt Street West, Suite 103 N9A 5M2