Career and Resume Reboot Intake Taking the First Steps Towards a Brighter Career Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 8 Welcome! This intake form is designed to help us get to know you and your career aspirations on a deeper level so we can tailor your coaching experience to your unique needs. Please take your time and answer each question thoughtfully—we’re excited to partner with you on this transformative journey! Purpose of this Intake Form The goal of this intake form is to assess workplace satisfaction and how life experiences impact it. Your responses will guide the coaching process and help you reflect on your career and future goals. Confidentiality Data from this intake form will not be reported on in any publications or presentations and will only be used to inform the coaching and consultation process. Risks and Benefits Completing this intake form involves minimal risk, no more than one might encounter in everyday life. While there may be no direct benefit to you, your participation is invaluable in contributing to our understanding of your workplace experiences, career background, general well-being, and work environment perceptions. Contact Information If you have any questions or concerns about this intake form, please feel free to contact us at hello@careerlogix.co NextCoaching and Resume Reboot IntakeNote: We understand that completing this intake form requires time and thought, and we deeply value your responses. During our time together, we’ll thoroughly review your answers and explore them further to ensure this process is fully personalized to your unique goals and career story. We have added a save feature that allows you to save and come back to the intake form at a later time. Please ensure you add an email address to save your responses so that the system can send you the link to open up the intake form again. Contact InformationName *FirstLastCurrent Job Title *Desired Job Title *Email *EmailConfirm EmailPhone *Address *Address Line 1CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryNextCareer Goals and PathWhat was your reason for seeking coaching and a new resume at this time? *--- Select Choice ---Career advancement or promotionJob loss or unemploymentDesire for a career changeLack of confidence in current resumeNeed to highlight new skills or certificationsPreparing for a job interview or networkingSeeking higher salary or better benefitsFollowing a company restructure or downsizingRelocation to a new city or countryStarting a freelance or entrepreneurial ventureReturning to the workforce after a breakAddressing gaps or inconsistencies in employment historyImproving personal branding and online presenceSeeking feedback on current resumeGaining clarity on career goalsOvercoming job search challengesOtherOther - Please Specify *What are your short-term career goals *--- Select Choice ---Gain new skills and certificationsSecure a promotion or new positionObtain feedback for improvementExpand professional networkImprove specific job-related skillsComplete ongoing projects successfullyIncrease productivity and efficiencyAttend industry conferences or workshopsDevelop leadership abilitiesContribute to team goalsOtherOther - Please SpecifyWhat are your long-term career goals (e.g., five years or more)? *--- Select Choice ---Advance to a managerial or leadership positionBecome an expert in my fieldStart my own business or ventureAchieve a senior or specialized roleGain international experienceDevelop new skills or certificationsContribute to industry innovationWork in a specific industry or sectorAchieve work-life balanceMentor or coach others in my fieldPursue further education or trainingBuild a strong professional networkContribute to community or social causesAchieve financial stability or independenceWrite publications or give talks in my area of expertiseAre you seeking remote work, hybrid, or office-based roles? *--- Select Choice ---Remote workHybrid workOffice-based rolesWhat motivates you in your career? *--- Select Choice ---Achieving personal growthMaking a positive impactFinancial stabilityRecognition and appreciationLearning new skillsCareer advancement opportunitiesWork-life balancePassion for the workHelping othersChallenging projectsCreative expressionAutonomy in workTeam collaborationJob securitySetting and reaching goalsPick the best response that aligns to your values.NextCareer Overview and Professional BackgroundWhat is your most recent role? What was the scope of your responsibilities? *This helps us to determine the level of your responsibilities. What accomplishments or achievements are you most proud of in your career? *Please list 3 accomplishments that you are most proud of and why. Short answers please. Provide a brief overview of your career history (key roles, industries, milestones). *Provide a brief summary only of your career history. Mention the last 3 positions only.Do you have leadership experience? *--- Select Choice ---YesNoNextResume and Skills AssessmentDo you have an updated resume? *--- Select Choice ---YesNoHave you ever worked with a resume writer before?--- Select Choice ---YesNoResume Writer ExperienceWhat technical skills, tools, or certifications are relevant in your industry, and do you possess them? *Specific the core skills only needed for your industry.Are there any skills you'd like to strengthen or gain for the next step in your career? *How would you describe your personal brand or value proposition in the workplace? *Your personal brand are qualities that are unique to you. Your value proposition is what sets you apart from other candidates. NextChallenges and ObstaclesWhat challenges are you facing in your job search? (e.g., getting interviews, finding the right roles, imposter syndrome, etc.) *--- Select Choice ---N/A. I have started my job search yetGetting interviewsFinding the right rolesImposter syndromeLack of networking opportunitiesResume writing difficultiesInterview anxietySkill gapsLack of feedback from employersOverqualification or underqualificationLimited job openings in preferred fieldGeographic constraintsTime management during job searchBalancing job search with current jobUnclear career directionAge discriminationFinancial constraints during job searchLack of confidenceDifficulty in showcasing skillsNavigating online application systemsManaging rejection and setbacksUnderstanding job market trendsWhat challenges are you facing in your current role? (e.g., lack of growth, burnout, toxic environment, etc.) *--- Select Choice ---Getting interviewsFinding the right rolesImposter syndromeLack of networking opportunitiesResume writing difficultiesInterview anxietySkill gapsLack of feedback from employersOverqualification or underqualificationLimited job openings in preferred fieldGeographic constraintsTime management during job searchBalancing job search with current jobUnclear career directionAge discriminationFinancial constraints during job searchLack of confidenceDifficulty in showcasing skillsNavigating online application systemsManaging rejection and setbacksUnderstanding job market trendsOtherOther Current Role Challenges - Please Specify *Do you have concerns about negotiating salary or compensation? *--- Select Choice ---YesNoDo you feel confident during interviews? *--- Select Choice ---YesNoAre there any gaps in employment or career transitions you'd like help addressing? *--- Select Choice ---YesNoHow do you feel about networking and building professional relationships? *--- Select Choice ---Very positive and proactiveGenerally positive but cautiousNeutral or indifferentSomewhat negative or hesitantStrongly negative or uninterestedHas anything from past career experiences created obstacles to achieving your career success? *Briefly explain what experiences could be attributing to these obstacles. Simply write "No" if there isn't anything.Have you experienced childhood or workplace trauma? *--- Select Choice ---YesNoWhat type of childhood or workplace trauma have you experienced? *--- Select Choice ---Emotional AbusePhysical AbuseNeglectBullyingHarassmentDiscriminationAccidents or InjuriesLoss of a loved oneWitnessing violenceFinancial hardshipWorkplace bullyingSexual harassmentVerbal abuseDiscrimination or biasChronic stress or pressureSudden job lossWorkplace accidentsHarassment or intimidationHarsh disciplinary actionsUnfair treatmentWorkplace discriminationOtherOther childhood or workplace trauma - Please SpecifyNextCareer Preferences and ValuesWhat is most important to you in your career? *--- Select Choice ---Career Growth OpportunitiesWork-Life BalanceSalary and CompensationJob SecurityMeaningful WorkRecognition and AppreciationProfessional DevelopmentFlexible Work ArrangementsPositive Work EnvironmentLeadership and Management SupportOpportunities for AdvancementCompany Values and CultureWork AutonomyJob StabilityImpact of WorkInnovation and CreativityHow do you define success in your professional life? *--- Select Choice ---Achieving career goals and milestonesMaintaining a healthy work-life balanceGaining recognition and respect from peersContinuously developing new skills and knowledgeMaking a positive impact in the organization or communitySecuring financial stability and growthLeading successful projects or teamsReceiving positive feedback from clients or colleaguesAdvancing to higher positions or rolesContributing to innovative solutions and ideasChoose the option that most closely aligns to your definition of career success.Are there specific organizations or industries you'd like to work for? *If yes, list the 3 top organizations and/or industries. If no, simply reply with "No".What values would you like your next employer or role to align with (e.g., diversity, sustainability, innovation)? *--- Select Choice ---DiversitySustainabilityInnovationIntegrityCollaborationExcellenceRespectCreativityAdaptabilityLeadershipWork-Life BalanceSocial ResponsibilityTransparencyCustomer FocusContinuous LearningInclusivityEnvironmental StewardshipEmpowermentAccountabilityTeamworkChoose the top value. Do you prefer a structured career path or flexibility and variety in your roles? *--- Select Choice ---Structured career pathFlexibility and variety in rolesChoose the top value. NextCoaching Goals and ExpectationsWhat specific outcome do you want to achieve from this career and resume reboot package? *Do you have a deadline or target date for achieving this outcome? *Are you comfortable implementing suggestions and feedback regarding your resume, interview style, or job search plans? *--- Select Choice ---YesNoWhat is your financial target for annual or hourly compensation in your next role? *--- Select Choice ---Less than $50,000 annually$50,000 - $75,000 annually$75,000 - $100,000 annually$100,000 - $150,000 annuallyMore than $150,000 annually$25 - $50 per hour$50 - $75 per hour$75 - $100 per hourMore than $100 per hour have resume, leadership Achievements and DreamsWhat is your greatest professional achievement so far? *If there were no limits (financial, educational, etc.), what would your dream role look like? *Is there anything else you'd like us to know before we begin?If no, simply say "No".Submit Intake Form
