Business Information Intake Form
Full Name
First Name
Last Name
Mobile Number
Your Email Address
example@example.com
Business Name
Business Main Telephone Number
What industry are you in?
Animal Products/Services
Auto Products/Services
Beauty Products/Services
Business Products/Services
Catering/DJ/Events
Child Care Services
Cleaning Products/Services
Consulting
Dentist
Electician
Florist
Government/Non-Profit
Health & Wellness Products/Services
Healthcare Provider
Home Improvement & Maintenance
HVAC
Insurance
Lawn Care
Legal Services
Locks & Locksmiths
Moving & Storage
Other Home Services
Photography
Plumbing
Real Estate
Roofing
Special Event Venue/Restaurant
Veterinarian
Wedding Products/Services
Other
What can I help you with?
What is your budget?
What are your specialties within your industry?
How many employees do you have?
0-3
4-8
More than 8
What stage are you in your business?
Start Up
Slow Growth
Re Structure
Quick Growth
Retiring and selling
Closing
Considering Starting
What is your unique market niche or why do people typically choose you over their other options?
How does diversity & inclusion show up in your business?
Does your business have a personality?
Adventurous
Bold
Conservative
Dependable
Edgy
Energetic
Friendly
Flexible
Healthy
Imaginative
Inventive
Jolly
Kind
Luxurious
Pratical
Sexy
Spiritual
Stoic
Tough
Warm
Wholesome
Other
Why is it important that your brand be inclusive?
How do you want people to view your business?
How do people find your website?
Search Bar
Social Media
Internet Advertising
Voice Search
Videos
Online Reviews
Blogging
Vehicle Wrap
Billboards
Mailers
Magazines
Radio Advertising
TV Ads
Other
Other
What are you wanting people to do when they find your business?
Book Services
Buy Something
Get an estimate
Find Information/Self Help
Other
How do you want people to connect with you?
Text
Email
Chat
Fill Out A Form
Book Online
Call
Other
How do you keep your day/notes/requests/work organized?
Pen/Paper
Free Calendar
Software Calendar
Other
How successful do you feel in getting a desired outcome from your current efforts?
I don't know
It's working but I need it to do more
It's extremely successful
Other
Choose a time for a free 30 minute consultation to discuss to your project further.
Thank you for your time!
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