Client Analysis Questionnaire
EWTECHNERD LLC
Fill in the information below.
Rows
Information
Company Name
Address
Contact Person
Title
Phone Number
Email
Website
When did you start your company?
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please indicate the location.
How do you plan to pay for your services
Please Select
Cash
Credit Card
Check
Please Describe your Business Start-Up
What Industry do you plan to participate ?
Please Select
Retail
Health
Beauty
Food
Technology
Other
Purpose of Seeking Services
Business Development
Marketing
Documentation Assistance
Financial Management
IT Solutions
Project Management
Business Coaching and Training
Book Publishing
Other
Company Annual Budgetary Constraints
Under $10,000
$10,000-25,000
Over $25,000
Initial Budget Allocated for This Project:
Under $1,500
$1,500-$10,000
$10,000-50,000
Over $50,000
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Have you worked with a consultant before?
Virtual or In-Person
Rows
YES
NO
Do you have a preference for virtual or in-person consulting?
Will you require a onsite meeting?
What are your preferred days and times for consultation sessions?
Is there any other information you would like to share that would help us understand your startup's needs better?
I understand that the information provided will be used by EWTECHNERDLLC for the purpose of preparing for the initial consultation and that mypersonal data will be handled in accordance with the privacy policy.
Yes, I Consent
No
Agreement to Pre-Pay: I, hereby agree to pre-pay for consulting services provided by EWTECHNERD LLC as outlined in the service agreement and proposal. I understand that this pre-payment is necessary to secure and schedule the consulting services. I have read the Consulting Disclaimer at https://ewtechnerd.com/consulting-disclaimer
Yes, I Consent
No
Signature
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Retirement/Exit Strategy
Describe the retirement strategy that you have in place:
Do you have any legal directives in place (Wills, Durable Powers of Attorney, Living Wills, Health Care Proxy)?
Do you have a Will or a Trust?
Do you own a piece of property?
Bank Accounts - List of Bank Accounts
Notes
Submit
Should be Empty: