Monthly Bookkeeping Services

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What Best Describes Your Organization

Mental Health Professional

Community Mental Health & Nonprofit

Wellness Professional

Allied Services

Other

2

What is the name of your practice?

3

What is the name of your Organization

4

What is your full name?

5

What is your email address?

example@example.com

6

Phone Number

Please enter a valid phone number.

7

What type of mental health practice do you operate?

Solo private practice

Group practice (2–10 clinicians)

Group practice (10+ clinicians)

Virtual-only

Hybrid (virtual + in-person)

Multi-location practice

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What Type of Business Do You Operate

9

How many billable clinicians are currently in your practice?

10

How long have you been in practice?

Under 1 year

1–3 years

3–7 years

7+ years

13

How many insurance companies do you bill monthly?

0 (Self-pay only)

1–3

4–6

7+

14

Do you need support with insurance reconciliation (EOB/ERA matching)?We verify every insurance payment is correct, nothing is missing, and nothing fell through the cracks

Yes

No

Not sure

15

How many financial accounts do you actively use each month? Checking Accounts or other form of Account

1–2

3–4

5–8

9+

16

How many financial transactions occur monthly across all accounts?

Under 100

101–250

251–500

Over 500

17

Do you have employees or 1099 contractors?

Employees

Contractors

Both

None

18

How many individuals receive payroll or payout calculations each month?Total Employees and Contractors

19

Do you pay clinicians based on commission/split-rate percentage?

Yes

No

Not sure

20

Which Practice Management/EHR system do you use?

21

Accounting System Used

QuickBooks Online

Excel only

Another platform

None

23

What additional support do you need? (Select all that apply)

Cash flow planning

KPI dashboards

Clinician revenue reports

Insurance contract review

A/R follow-up support

SOP creation or improvement

None

24

Do you need Tax Preparation Services through QleanBooks?We partner with licensed tax professionals to offer full-service tax preparation for mental health practices. Select all that apply.

Yes, I need Individual Tax Preparation (Form 1040)

Yes, I need Business Tax Preparation for my Practice (1065, 1120-S)

Yes, I need both Individual and Business Tax Preparation

No, I already have a CPA

No, I do not want tax services

25

What type of business entity do you operate?

Single-Member LLC (Disregarded Entity)

Multi-Member LLC / Partnership

S-Corporation

C-Corporation

Sole Proprietor

Not sure

26

Did you file a tax return for your practice last year?

YESNO

27

How many owners does your practice have?

28

Do you need tax planning during the year?

Yes – quarterly tax estimates

Yes – annual planning only

No

29

Do you receive income outside of your practice that must be included on your return?

W-2 Employment

1099 Contract Work

Rental Property

Investments (stocks, dividends, crypto)

Other

None of the above

30

Are you currently behind on any tax filings?

YESNO

31

Do you have payroll in your practice?

YESNO

32

How organized is your bookkeeping for tax purposes?

33

Do you require support with 1099 filings for contractors?

YESNO

34

Expected number of clinicians/contractors needing tax statements

35

Additional comments or special tax circumstances

36

Please include any additional notes about your practice, goals, or challenges

37

What is your Estimated Monthly Budget for this Project

$350 - $850 per Month

$850 - $1450 per Month

>$1,500 per Month

Not Sure

38

Your Estimated Monthly Bookkeeping Service isThis estimate is based on the information provided and will be honored if confirmed without material changes to scope.

39

Your Estimated Monthly Bookkeeping Service isThis estimate is based on the information provided and will be honored if confirmed without material changes to scope.

40

How would you like to proceed?* This field is required.

Schedule a Discovery / Introductory Call

Send Me an Engagement Letter to Get Started

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