Coaches Creating Impact Inc.: Intake Form
Name
First Name
Last Name
Email address
Birthday
-
Month
-
Day
Year
Date
Mailing address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
Instagram
Facebook
LinkedIn
Are you working another job right now?
Yes
No
What kind of business do you run?
How long have you been working on this business?
Who is your ideal client?
What is your main offer(s)?
How long have you had these offers?
What is your average monthly revenue?
What was your highest monthly income as an entrepreneur?
Which platform have the bulk of your clients come from?
How many clients are you currently working with?
Do you find it hard to be consistent with content creation?
Yes
No
Sometimes
Do you batch and produce content ahead of time?
Yes
No
Sometimes
On average, how many sales calls do you have weekly/monthly?
Out of 10 sales calls how many will you close? (don't be too positive)
Do you have a Facebook group, email list, blog, or podcast?
How fast is your audience (IG, FB, email) growing on a monthly basis?
How many referrals do you get from current and past clients?
How long does your average client work with you?
Do you have any tasks outsourced or are you the solo act for EVERYTHING in your business?
What numbers do you currently consistently track in your business?
Do you have any time during the week you cannot work?
How many hours a week do you have to put towards this?
What is your income goal in the first 90 days?
What is your income goal within the next 6 months?
If we achieved
in the next 13 weeks YOU would be ECSTATIC
What do you feel has been the biggest hurdle preventing you from achieving this goal previously?
When you get stressed or frustrated, what is the best way for us to coach you? Push you really hard? Be super relatable? Get tactical?
How hard do you want to be pushed in CCI? 1 being, "I don't want to be pushed really", 10 being "Push me so hard I cry, but I know it's good for me"
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
Were you directly introduced to CCI by someone through a group chat or email?Please list their full name(s) below. Note: This only qualifies as a referral if there was a direct introduction via group chat or email.
Did anyone play a role in supporting or encouraging you to join CCI (for example, sharing their experience or having a call with you)? Please list their full name(s) below. Note: This does not count as a referral as they were not your initial introduction to CCI but they may be eligible for an advocacy bonus.
Do you acknowledge that until you have returned your signed contract that your coaching services cannot begin?
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