Intake Form
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Business Name (if you have one)
Website Address (if you have one)
Provide a brief overview of your business, including its history, core values, and mission statement? If you are an employee, please describe what you do in detail.
Who is your current customer base, and what demographics do they typically fall into (e.g., age, gender, location, income level)? Enter N/A if this does not apply.
What specific products or services do you offer, and what sets them apart from competitors in your industry? enter N/A if this does not apply
What are your short-term and long-term business goals, and how do you envision achieving these goals? What do you want?
What inspired you to join this community and what goals do you aim to achieve within it?
Are there specific obstacles that you feel are in your way of achieving your goals?
Are there any particular coaching styles you prefer? For example, more step by step, more direct, more gentle? This is just to give me an idea of your preferences!
How would you describe the overall current situation you are in now? What needs to change quickly?
Can you provide examples of what you've accomplished in the past 12 months, share your wins with me!
IF you are building an online business, coaching, training, What emotions or feelings do you want your branding to evoke in your target audience? For example Confidence & Empowerment, Authenticity & Self-Expression, Elegance & Sophistication, Trust & Professionalism, Joy & Transformation, etc.
Are there specific outcomes you are seeking in coaching with us? Please, be as detailed as possible, the more I know, the better we serve you.
What is your commitment to move forward with your desired goals that you wrote earlier? What are you willing to do to get there?
Do you have any specific questions you want addressed?
What is the core thing about you that you want to communicate?
What are the key values and principles that define you, as a person and as a business owner, if that is the path you are on?
Can you share with us, a time in your life that was most joyous? How did you feel, What were you doing?
Any additional information you think is important for us to know?
Where do you feel you are financially? Do you keep a Cash Flow plan (Budget)?
Thank you for completing this Intake Form. Is there any other information about your company, or yourself you feel we should know?
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