Intake Tell Me About You Form

Tell Me About You

This information will help me with the creation of your customized organizing plan.
Name *

First Name Last Name
What is the best email for you? *
Address *

Street Address

Street Address Line 2

City State

Zip Code
Best Phone Number to reach you *
Can you accept text messages at the above number? *

Yes No
Your age range

20-45 45-65 65+
# of household members, include those who are there on a routine basis
Square footage of home *
# of bedrooms in home
# of offices/spare rooms in home
Additional spaces in your home where you store things

Attic Basement Garage Other
What spaces need to be organized the most?

Office or Hobby Room Bedrooms Closets only Shared living spaces Attic, basement, and/or garage Other
When you want to get organized, do you.... *

not know where to start and don't spend a lot of time moving stuff and get very little done get everything organized but it gets disorganized quickly organize and it stays that way Other
Have you experienced an event that significantly impacted your household?

Yes No
Do you have an upcoming event that will significantly impact your household?

Yes No
When our work together is done, what will you be able to do that you can't do now or are having a hard time doing now?
e.g. cooking with the kids, enjoying time to read, having guests
Do you think you feel different from organized people?

Yes No I'm not sure
If yes, how do you think you feel different?
Lifestyle
What is your occupation?
homemaker, marketer, lawyer, etc.
If employed, do you work:

Outside the home, Monday-Friday, 9-5ish In the home, Monday-Friday, 9-5ish Outside the home, non traditional hours In the home, non traditional hours
What clubs, memberships or organizations take up your time?
e.g. fitness routine, business or social networking
What children's activity take up your time? Include even if only driving your children.
e.g. sports, extra curricular activities, school activities
Do you have a side hustle or passion project that takes up your time? If yes, please list activity.
Do you have any responsibilities regarding elder care or home care of others?
What are your interests and/or hobbies?
What other interest of yours did I miss?
Your Own Physical Challenges
Any back or mobility issues

Tell Me About You

Lifestyle

Your Space