INTAKE FORM FOR GOSPEL COACHING WITH A DISCIPLE
This form is helpful in establishing a gospel coach and disciple relationship. It facilitates the coach’s getting to know the disciple and establishes a starting point for the journey toward Jesus and his calling in the disciple’s life. Feel free to revise this form to include only questions that will be beneficial for your particular gospel coaching relationship. This list is quite comprehensive and is meant to be selectively utilized.
(1) Tell me about your family [spouse, children’s names and ages, etc.].
(2) When is your birthday? Anniversary?
(3) What makes you excited or feel really alive?
(4) What are some skills and talents that God has blessed you with?
(5) What have been lifelong desires and dreams for you? What is going on with these dreams and desires now?
(6) What are you hoping for in the next six months?
(7) How has God saved you personally? How is he saving you daily?
(8) How would you describe a “perfect day”?
(9) How would you describe a “terrible day”?
(10) How is ministry impacting your family?
(11) How is your family impacting your ministry?
(12) How is your ministry impacting your faith?
(13) How is your faith impacting your ministry?
(14) How is your personality affecting others?
(15) How are others affecting your personality?
(16) How is your integrity impacting others? What people are you influencing both positively and negatively?
(17) How is your character influencing your culture?
(18) How is your character influencing your church community?
(19) How are you developing character in your leaders?
(20) How is your physical health? What does your exercise look like weekly? What do you do for recreation? What does your eating look like daily? What does your sleep and rest look like? Do you have any health issues that affect your life and ministry? How are you dealing with these?
(21) How is your emotional health? How is ministry affecting your emotions? How are your emotions affecting your ministry? What tone are you setting in your home through your emotions? What tone are you setting in your ministry through your emotions?
(1) What area of your character in your personal life are you most convicted about by the Holy Spirit? What do you envision this developed area to look like? How would you describe this area now? What things could you do to develop or grow in this area? What commitment do you have to grow in this area? What has made it difficult for you to see growth or change in this area?
(2) What is currently confusing you about the gospel on a heart level?
(3) What books are you currently reading? What are you learning?
(4) How can I encourage, help, and support you?
(5) How are you making space to be refreshed in God’s salvation in a personal, practical way?
(1) What is holding you back from personal growth in Jesus?
(2) What are you holding on to that is keeping you from being more like Christ?
(3) What current personal failures are most frustrating to you?
(4) What has God accomplished in your character in the last year?
(5) How has God shown faithfulness to you in the last year?
(6) How are you and God doing?
(7) Where do you think God wants you to go in your personal growth in the next six months? Why?
(1) Who do you need to help you?
(2) To whom will you be accountable?
(3) How can I help you?
(4) Where do we really need God to show up?
(5) Where is your heart hard?
(6) What lies do you believe?
(7) What doubts have crept in?
(8) In what ways have you invited unbelief and deception in your personal life? How can I help close those doors?
(9) How will we pray?
(1) How would you describe your personal call?
(2) What people and circumstances are associated with your call to ministry
(3) How and when has your call to ministry been affirmed in your life?
(4) How have others affirmed your call to ministry?
(5) What opportunities do you have to fulfill this calling?
(1) What leadership gifts or abilities do you need to develop to fulfill your calling or current assignment?
(2) How would you describe your current abilities in this area?
(3) What options do you have to develop your leadership?
(4) What will you do to develop your leadership?
(1) When has your call to leadership been challenged?
(2) Under what circumstances have you doubted your call?
(3) Is there anything in this current experience that is causing you to question your call?
(4) What activities or events do you use to anchor, form up, or strengthen your call?
(5) How should your call be focused or clarified?
(6) What does your call’s success look like?
(1) Who have been mentors in your life?
(2) What mentors and coaches do you need now to fulfill your call?
(3) Who else do you need to help you?
(4) What do you need most from God right now?
(1) What are some of the major milestones in your theological development?
(2) What are you reading in Scripture right now? What are you learning about God?
(3) How do you practice abiding in Jesus?
(4) What increases your affections toward God and others?
(5) What deadens your affections toward God and others?
(6) What is causing your anxiety or fear right now?
(1) What are some areas with which you wrestle theologically?
(2) What information are you missing?
(3) How hungry are you to know God?
(4) How dependent do you feel on Jesus in your life?
(1) What discrepancies may be emerging between what your mind knows and what your heart believes in Scripture?
(2) How is the Holy Spirit leading you to grow in your understanding of Jesus?
(3) What does your prayer life look like?
(4) Who are the people in your life you are praying for?
(5) What are you praying for?
(6) What are your prayers revealing about your faith?
(7) Who is effectively bringing you clarity about who Jesus is and about the truth of Scripture? How are you prioritizing these people in your life?
(1) What are you feeding yourself with to feel satisfied outside of Christ?
(2) What current obstacles hinder your spiritual growth?
(3) Who is pulling you away from your relationship with God? How?
(4) Who is planting doubt and discouragement in your heart about Jesus?
(5) What anti-Christian spiritual teaching are you tempted to believe? Why?
(6) What are you allowing to take priority over your relationship with Jesus? Why?
(7) What obedience has Jesus called you to that you have been ignoring or trying to escape?
(1) What opportunities for mission are present in your life?
(2) Who are the lost people God has brought into your life? What does your relationship with these people look like?
(3) What percentage of your time is spent with people who do not know Jesus?
(4) What are your spiritual gitfs?
(5) Describe your current ministry and missional responsibilities? Do these match your calling? Are any of these activities being performed under compulsion?
(6) To what degree do you and your church understand the prevailing culture in your city?
(7) How do you and your church engage the culture?
(8) How do you and your church serve the culture?
(9) How and where do you and your church attract the culture?
(10) How and where do you and your church initiate relationships in the culture?
(11) How is your church perceived by the culture?
(12) How do you and your church receive the culture?
(13) How do your leaders impact the culture?
(1) Where is ignorance in your mission or ministry killing you?
(2) Are you experiencing any physical or emotional burnout? How easily discouraged are you in your mission? How is your patience quotient? Are you easily angered in your ministry? Are yu disconnecting completely from your mission for Sabbath? How?
(3) Which Christian missiologists have influenced and shaped your mission through their writing or preaching?
(4) How would you like to see your church connect with culture?
(5) What can you personally do to connect with culture?
(6) What is working now in connecting with culture?
(7) What other possibilities do you see for you or your fellowship to connect with culture?
(1) What does success in your mission look like?
(2) How will you know when you are accomplishing what God has called you to?
(3) How close are you to that success now?
(4) What roadblocks are you experiencing in accomplishing your mission?
(5) Is the direction you are headed the direction to which you have been called?
(6) Where and how have you and your church been effective in reaching into your culture?
(7) Which of your leaders most impact the culture?
(8) Who are the persons of peace with whom you are connecting?
(9) Where has there been a significant network of evangelistic relationships?
(10) What is stopping you or your church from engaging or impacting culture?
(11) What are one or two things could you and your church do to understand, engage, or receive your culture?
(1) What is draining your energy and sapping life from you in your mission?
(2) Who is attacking your mission — intentionally or unintentionally?
(3) What voices of discouragement are you listening to?
(4) What personal sins are hindering your mission and calling?
(5) Where are you allowing cowardice to hinder your mission and leadership?
(6) Where are you charging ahead of the Holy Spirit in your own strength?
(7) Who has sinned against you, and how is it affecting the mission?
(8) Who have you sinned against, and how have you dealt with it?
(9) What keeps rising up to distract you and your people from the mission?
(10) What risks are you willing to take to demonstrate dependence on God?
(11) What can help you understand your culture?
(12) Where do you most need God’s help?
(13) How are you praying for needs in the culture?
*SOURCE: Adapted from Appendix 2 in Gospel Coach: Shepherding Leaders to Glorify God by Scott Thomas and Tom Wood. Wheaton: Crossway Books, 2013.