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Service Interest Questionnaire

Please fill out the form below to give us some additional insight into your business and needs.

Name(Required)

First Last

Your Preferred Correspondence Email(Required)

Phone Number(Required)

Website

Website #2 (if applicable)

Goals and Objectives

What are your Top3 goals for the year?

What 1-3 things would you like to accomplish in the next 3 months?

What 1-3 activities do you know you "should" be doing but haven't gotten around to doing yet?

What 1-3 activities are you doing that you don't know if you should be doing?

Most of us tell ourselves that at some point when we have everything else in place, we'll do the thing *we* most want to do. What's that thing for you?

What do you see as your Top 3 challenges to reaching your goals?

How do you think I can help you?

Financial Questions

While your business's financial pulse isn't the *only* or sometimes most important *pulse*, this gives me a snapshot of what you've built and what we have to build with.

What was last quarter's Earn rate?

(Earn = total revenue)

What was last quarter's Burn rate?

(Burn = how much it cost for overheads, teammates, and your own salary)

What's your Goal rate for every quarter?

(Goal = how much you're actively working to earn. Note: it need not be more than your Earn rate)

Does your business regularly provide *you* with sufficient income through some combination of payroll, dividends, or draws?

Yes

No

I don't know

Questions That'll Help Me Be A Better Guide for You

Which engagement options are you interested in?

(check all that apply)

A half-day strategy session to get clear about your next steps and strategic priorities

A six-month one-on-one coaching/consulting engagement where we co-navigate your biggest challenges and opportunities

A team workshop to improve your team's alignment, focus, and performance

A team leadership or strategy execution engagement

A strategy retreat or offsite for you or your team

Have you worked with a coach or consultant before? If so, what worked well for you? What didn't work well?

If we decide to work together, may I publicly share that we’re working with each other?

(This makes it easier for me to indirectly promote you.)

Yes

No

Where did you find out about my services?

Anything else you'd like to say or want me to know?

Use this to send me any files you think I should have.

(Please zip them into one package.)

Accepted file types: zip, Max. file size: 50 MB.

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