LAD Client Information Request Form
Tell us a little more about your needs in preparation for our call.
Date
-
Month
-
Day
Year
Date
Business/Agency Name
Your Name
First Name
Last Name
Title/Role
Email
example@example.com
Where did you connect with us?
Conference
Networking Event/ Expo
Direct Communication
Other
In which area of the business are you experiencing the most challenge?
Culture
Management & Supervision
Leadership
Technology Shifts
Operations
Learning & Professional Development
Programs (Development, Implementation, Monitoring)
Ongoing Monitoring & Compliance
Infrastructure Development (Policies, Processes, Practices)
Constant crisis/ Too many fires
Effective Practice
Performance & Motivation
Engaging the Community/Stakeholders
Other
What services are you interested in?
Change Management Consulting (Culture, New Leadership, Transitions)
Organizational Development Consulting (Compliance, HR, Infrastructure)
Development & Coaching Programs
Professional Development & Training
Custom Blend
Other
How quickly are you looking to begin?
Immediately! We can't move forward like this.
We'd like to begin within 2-3 weeks.
This is not an urgent concern but we'd like to begin developing a plan for implementation within 2-3 months.
These are proactive solutions that will help us maintain a strong foundation. We want to begin in 6 months.
Other
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