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Stakeholder Input Form

Thank you for taking a few minutes to complete this form.

This input is being gathered to support a coaching process for your direct report. The goal is developmental. It is not a performance evaluation.

Your responses will be used to identify patterns, clarify priorities, and shape the coaching focus. Please be specific, behavioral, and constructive. Focus on what you have directly observed.

Please avoid labels, assumptions about motives, or secondhand information whenever possible.

Section 1: About You and the Working Relationship

1. Your name

2. Your title / role

3. Coachee’s name

4. What is your working relationship to this person?

4. What is your working relationship to this person?
A
B
C
D

5. How long have you worked with this person in a meaningful way?

5. How long have you worked with this person in a meaningful way?
A
B
C
D
E

6. How frequently do you interact with this person?

6. How frequently do you interact with this person?
A
B
C
D
E

Section 2: Current Strengths to Preserve

7. What are this person’s most valuable strengths?

Please name 2 to 3 strengths that you believe are important for this person to preserve and continue using.

8. Where do you see these strengths showing up most clearly in their work?

Please give one or two specific examples.

Section 3: Priority Development Areas

9. What are the top 2 to 3 areas where growth would most improve this person’s effectiveness?

Please focus on the few areas that matter most. Think in terms of behaviors, habits, communication patterns, leadership moves, or execution.

10. Of the areas you listed, which one feels most important right now?

Section 4: Observable Examples

12. Please describe one specific example that illustrates the main growth area.

What happened? What did the person do or not do? What was the effect?

13. Is this example best described as:

13. Is this example best described as:
A
B
C
D

14. What impact does this behavior or pattern have?

14. What impact does this behavior or pattern have?

15. If you selected “Other,” please describe it.

Section 5: Desired Change and Success Indicators

16. If this coaching is successful, what would you hope to see more of from this person over the next 90 days?

17. What would be the clearest signs that progress is happening?

Think in terms of visible, observable behavior.

18. Are there any upcoming situations, responsibilities, or challenges that make this coaching especially timely?

Section 6: Support and Shared Accountability

19. What support does this person most need from you in order to make progress?

20. What are you willing to do to support this person’s development during the coaching process?

Examples might include clearer feedback, more frequent check-ins, better context, space to practice, or reinforcing progress.

21. Are there any conditions in the team or work environment that may help or hinder progress?

Section 7: Additional Perspective

22. Is there anything else you believe would be helpful for the coaching process to consider?

23. Please confirm the following:

23. Please confirm the following: