Potential Client Questionnaire
This information will be used to assist in determining if our firm can assist with your accounting, tax, and advisory needs.
Estimated time to complete:
less than 5 minutes
Date of Form Completion
-
Month
-
Day
Year
Date
Contact Information
Contact Name
First Name
Last Name
Primary Email
example@example.com
Contact Phone Number
Please enter a valid phone number.
Business Name
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Entity Type (select all that apply)
Individual
Individual w/ Sch C
Individual w/ Sch E
Individual w/ Sch F
Trust
C-Corp
S-Corp
Partnership
Estate
Non-Profit
What does your company do?
Accounting Services
Agriculture
Architect
Construction - New Homes
Construction - Remodel
Consulting
Education/Training
Financial Planning Services
Health Services
Insurance Agent (Commission Income)
Legal Services - Attorney
Management Services
Manufacturing
Performing Arts
Real Estate Agent (Commission Income)
Retail Sales
Skilled Trade - Electrician, Plumber, Etc.
Other, please list
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Current CPA
Referred By
Relation to an Existing Client
What are you looking for in a new CPA?
How can we help you?
On a scale of 1 - 10 (with 1 being the least), how knowledgeable are you about how your taxes are structured or how your taxes work?
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Meeting Preferences
What time of day would you prefer to meet?
AM
PM
No Preference
What day(s) work best for your schedule? (select all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
You are almost DONE! Review the two items below.
SUBMIT YOUR ANSWERS
: Once complete, click "Submit Answers" to transmit your response to our office. Select "Save for Later" if you'd like to edit responses prior to submitting.
YOUR ANSWERS WILL BE REVIEWED
: We will review your submission to determine next steps Thank you for your time in completing this form!
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