Salt+Grit
Leadership Coaching Intake Form

Legal Name

First Name

Last Name

Preferred Name

Preferred Pronouns

Phone

(###)

###

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What is the best way to reach you? (phone, text, email)

What are you most excited about exploring/discussing in your coaching sessions?

Think of a recent professional moment when you felt energized. Describe this moment.

What energizes you outside of work?

Do you feel you have overlapping goals in your personal and professional life? If yes, please describe.

What are you hoping to feel or experience in six months from now?

Are there challenges or fears that might get in the way of achieving this feeling or experience? If yes, please describe.

What are your top five values?

Who are the people in your support system and how do they support you?

What questions do you have about Salt+Grit's leadership coaching program?

Please share any additional information that might help us better serve you in reaching your coaching goals.