New Client Intake Form:
Client Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Job Title
Company Information
Company Name
*
Company Website Link
*
Company Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Company Industry
*
Managed Service Provider (MSP)
Technology Company (Non-MSP)
Behavioral Health Services (Therapy/ Psychology/Mental Health Offices)
Legal
Staffing/ Recruiting
Other
Company Size (Total number of employees)
Company Culture Assessment (Select the 2 categories that describe your company best)
*
Collaborative & People-First (Supportive, relationship-driven, teamwork-focused)
Innovative & Rapidly Evolving (Creative, experimental, constantly improving or changing)
Competitive & Performance-Driven (Goals, metrics, high achievement, ambitious environment)
Structured & Process-Driven (SOPs, clear roles, predictable processes, organization-heavy)
Fast-Paced & Urgency-Driven (Quick decisions, rapid workflow, time-sensitive tasks)
High-Pressure & Client-Facing (Real-time problem-solving, demanding customers, emotional intensity)
Calm, Stable & Low-Drama (Predictable, steady rhythm, minimized chaos or surprises)
Independent & Self-Directed (Ownership-driven, minimal oversight, high autonomy)
Flexible & Laid-Back (Informal environment, high trust, results > rules)
Analytical & Detail-Heavy (Data-first, accuracy-focused, methodical work style)
Company Benefits Package (Please include total benefits including health insurance information, 401k, certification reimbursement, PTO, Maternity/Paternity leave, etc.)
Position Looking to Fill Information
Job Title
*
Base Salary Range
Salary Type (Select all that apply)
Hourly
Salaried (not hourly)
Commission
Bonus Opportunities
Job Description
Please provide a brief description of the role you are looking to fill, including key responsibilities and objectives.
*
Job Description (If Available)
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Qualifications and Requirements
Years of Experience Required
Professional Certifications Required (If Any)
Education Requirements:
*
Associate Degree (AS/AA)
Bachelor’s Degree (BA/BS)
Master’s Degree (MA/MS/MBA)
Doctorate Degree (PhD/EdD)
Juris Doctor (JD)
Medical Degree (MD/DO)
Degree is Preferred but Not Required
Degree is Not Preferred OR Required
Other
Technical Skills/Software Proficiency
Job Location and Work Arrangement
Location this person must commute to (if different from company address):
(Street, City, State, Zip)
Is this position in office, hybrid, or remote?
*
5 days In Office
Hybrid In-Office and Remote Set Up
Full Remote
I Am Not Sure Yet or Open
Work Hours
*
Full-time
Part-time
Target Candidate Profile
Provide at least 3 candidate characteristics (Soft Skills) that are most important for this position (Examples: Communication, Client-Facing, Independent, Creative, Calm Under Pressure, Self-Motivated, Team Oriented, etc).
Describe Your Perfect Candidate in a Few Words:
Trajectory of the Role (What are the growth opportunities for this individual?)
Recruitment Timeline
Desired Start Date
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Month
-
Day
Year
Date
Additional Information
Include any additional information, such as special requirements, challenges you have faced in your search, or other relevant details.
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