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Success Coaching Interest Form

Thank you for your interest in Tulane’s Academic Success Coaching program. Tulane Academic Success Coaches are professionals who support undergraduate students in their academic, personal, and career success. Through regular one-on-one meetings, coaches assist students in exploring their unique processing styles and ingrained habits and beliefs, as well as creating actionable steps to meet student goals. Coaches frequently partner with students on the following topics: executive function concerns, neurodiversity, time-management, motivation, testing anxiety, stress management, college transition, and decision-making.

You will be contacted by a success coach regarding next steps after submitting this form. Questions? Want to chat with a success coach? Email success@tulane.edu and we will be happy to connect. Thank you!

Tulane ID: *

Today's Date: * +

First Name: *

Last Name: *

Preferred Pronouns

Email Address: *

Which of the following financial aid resources are you utilizing this year?

Are you the first person in your immediate family to attend college?

Yes

No

Number of study hours per week:

In addition to class, what other obligations do you have?

Which of the following have impacted your ability to be successful? Please check all that apply.

Academic

My approach from high school no longer applies

Study skills/strategies

Test taking skills/strategies

Test anxiety

Difficulty concentrating/daydreaming

Class absences

Conflict with professor/classmates

Difficulty with course content/underprepared

Course content/style not engaging or challenging

Personal

Inability to get motivated

Difficulty sleeping/oversleeping

Overwhelmed, stressed, anxious or tense

Health challenges

Alcohol or Substance issues

Difficulty prioritizing/managing time

Financial difficulties

Distracted/overuse of technology

Overinvolved in activities (including work)

Major/Career

Undecided major/changed major multiple times

Unclear on job options for my major

Unclear about professional goals

Uncertain about commitment to Tulane

Family/Social Adjustment

Homesickness

College transition has been difficult

Difficulty making friends/finding social activities

Personal relationship challenges

Family stress/challenges

Do you have a medical diagnosis that you wish to disclose to your Success Coach? (This information will ensure that our coaches are connecting you with the most appropriate resources.)

Who referred you to success coaching?

What Goals would you like to achieve in coaching this semester? (Academic, Personal, and Career Goals)

Please rank the following statements from 1 to 5, where 1 is the least amount, and 5 is the most amount:

How important is it to reach your goals this semester?
How confident are you in your ability to reach your goals?

Which of the following are you willing to do in coaching to work toward your goals:

Partner with someone to develop plans to reach specific goals

Experiment with new and different approaches to achieve goals

Personal reflection

Modify or eliminate behaviors that limit my success

Take part in a collaborative process with a coach and give feedback when appropriate

Attend weekly or biweekly meetings with a coach and arrive on time

How will you measure your success in coaching?

GPA, Grades, or other Academic Measures

Accomplishment of goals

My emotional and/or physical well-being

Other Other

What are your greatest strengths?

What helps you bounce back in the midst of setbacks?

What gives you energy? (Think: activities, interests, hobbies, environments, people, etc.)

What else should we know about your current situation?