First Name *

Last Name *

Email *

Phone *

How did we find each other? *

In your own words: what is your work in the world... and why does it matter? *

Why did you decide to say yes to a discovery session at this moment in time – what speaks to you about receiving support, what inspires you, and what are your needs that you feel the session can help address? *

Which of these best describes your work? *

Which of these best describes your role at work? *

If you are responsible for a team, approximately how many people do you lead or manage? *

Would you like to be “having a greater impact” in 6-12 months? If so, describe what you imagine that could entail. (yes! give me the juicy details... what do you really want?) *

What would “having a greater impact” look like for you, in your life, work or personal legacy? *

What are your greatest strengths as a person or as a leader, and how do you use them for good? *

What's your biggest "Achilles Heel" in your leadership or personal life – and how does it currently get in your way? *

What have you already done (or what are you are currently doing) to improve the situation? *

On a scale of 1-5 (1 being not important, 5 being urgent), how important is it for you to achieve your goals this year? *

Urgency of success (scale of 1 in the next year to 5 like tomorrow please) *

What is your approximate annual income? (we ask this question for program scholarship purposes) *

Are you satisfied with your current income? *

Are you interested in a Guts & Grace Program? *

Guts & Grace Mastermind

Activate Course

Guts & Grace Retreat or Activate Summit

Either / All

None, I prefer solo executive-level coaching

Not Sure

Have you ever worked with a coach? If "yes," what was your experience? *

The majority of our clients invest in their own coaching. This gives them the flexibility to truly set their own goals and change jobs if/when the time is right. However some clients do have a company budget to spend. If we were to work together, would you be planning to invest in your own coaching? *

In order to be considered for a discovery session please respond to the following statement: *

I agree to be 100% open and coachable during our call. I am prepared to be present, to be honest, and am willing to take action in my life.

Last but not least - imagine it's a year from now... and everything you dreamed of is happening. Describe what your life looks like (including success, income, relationships, energy, time, freedom, health, impact... you decide what matters!) *

Thank you for your time and honesty in filling out this survey, please review/revise any answers if needed, then click submit to submit your entries.