Business Services - Intake Form

Business Services - Intake Form
Business Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Owner Name

First NameLast Name
Owner Title
Email
example@example.com
Cell Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Website
Year Business Started
Estimated Annual Revenue
Number of Employees

Full-timePart-time
Number of Full-time
Number of Part-time
Name of Financial Institution (check all that apply)

AllSouth Federal Credit UnionBank of AmericaFirst Citizens BankFirst Community BankNavy FederalOptus BankRegions BankSAFE Federal Credit UnionSouth Carolina Federal Credit UnionSouth State BankSynovusTD BankTruist BankWells FargoOther
Legal Structure

Sole ProprietorshipLimited Liability Company (LLC)Limited Liability Partnership (LLP)S-CorporationC-CorporationNon-profitOther
Industry

AgricultureConstructionExporting/ImportingFood ServicesHealthcareInformation TechnologyManufacturingProfessional ServicesRetailOther
Description of Services/Goods Offered
Briefly describe your goals and needs
Which of the following areas present challenges to your business? (check all that apply)
Financial Management

Cash flow managementProfitability issuesBudgeting constraintsAccess to funding and investmentDebt managementPricing strategy difficulties
Strategic Growth & Challenges

Innovation and staying competitiveDeveloping new revenue streamsBusiness scaling difficultiesMarket expansion risksAdapting to industry trendsMarket fluctuations and economic downturnsInflation and cost of materialsSubcontracting/Teaming
Operational Challenges

High operational costsProductivity concernsInefficient processesSupply chain disruptionsEquipment or technology failuresInventory management issues
Marketing & Sales Challenges

Customer retentionReaching the target audienceBranding and positioning issuesDigital marketing struggles (SEO, social media, etc.)Market competition
Human Resources & Talent Mangement

Employee retention and turnoverRecruitment challengesWorkplace culture and moraleTraining and skill developmentCompliance with labor lawsLeadership and management gaps
Legal & Compliance Challenges

Contractual disputesAdhering to industry regulationsTax complianceLiability risksEmployment laws
Technological Challenges

Cybersecurity threatsKeeping up with digital transformationSoftware integration issuesData privacy and complianceOutdated systems and infrastructure
Management Challenges

Succession planningContingency planningDecision-making difficultiesManaging change and business transformationDelegation and accountability
How did you hear about us?

DESA websiteInternet searchFlyerReferred by AgencyReferred by Individual
Information
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Business Services - Intake Form

Which of the following areas present challenges to your business? (check all that apply)