Virtual Assistant Client Intake Form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Instagram Handle* This field is required.
4
Website / Blog URL(if applicable)
5
Where did you find me?* This field is required.
Instagram
Facebook
Google
Referral
Pinterest
TikTok
LinkedIn
Other
6
Which type of VA support are you looking for?* This field is required.
Admin Support (Inbox management, file organization, client/project management, documentation)
Marketing & Strategy (Pinterest growth, email marketing, content writing, lead generation)
Social Media Management (Content creation, scheduling, engagement, monitoring)
Tech & Automations (Funnels, automations, website development, video editing, Canva design, project management)
Affiliate & Creator-Specific Services (Collage design, Amazon/Wayfair management, LTK, newsletters, SEO, crossposting)
Other
7
Can you describe your current workload?* This field is required.
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Large
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Small
Ok
Ok
8
What’s your niche or content style?* This field is required.
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Small
Ok
Ok
9
What goals are you hoping VA support will help you reach?* This field is required.
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10
What's your LTK Handle?* This field is required.
11
Do you currently use other platforms for affiliate marketing?* This field is required.
Amazon Storefront
ShopMy
Wayfair Storefront
No
Other
12
What type of content do you create most?* This field is required.
Fashion
Home
Beauty
Lifestyle
Travel
Other
13
What is your biggest struggle with LTK/Amazon/Wayfair/ShopMy right now?* This field is required.
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Ok
14
What’s your main goal for the next 3-6 months with LTK/Amazon/Wayfair/ShopMy?* This field is required.
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Ok
15
What is your biggest struggle with your business right now?* This field is required.
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Ok
16
When would you ideally like to start?* This field is required.
17
How many hours per week do you anticipate needing?* This field is required.
20 hours/week
25 hours/week
30 hours/week
35 hours/week
40 hours/week
18
Anything else I should know or questions you have?* This field is required.
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Small
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Ok
19
Have you already booked a free discovery call with me?* This field is required.
YESNO
20
My schedule is almost full. If I’m fully booked, would you be open to a dedicated VA from my agency (under my supervision) to handle your needs with priority? Rates are still around $15–35/hr, 15hr/week minimum.* This field is required.More info: www.nextlevelvirtuals.com/services
Yes, no problem — as long as the work ethic and output stay the same.
No, I’ll look for another VA instead if you confirm you’re already fully booked.
Other
21
How would you like me to contact you?* This field is required.
Email
WhatsApp
22
How would you like me to contact you?* This field is required.
Email
WhatsApp
I’d like to have a quick call with you
23
What's your WhatsApp Number?* This field is required.
24
Choose your preferred date and time.* This field is required.
Should be Empty: