Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What is your title? (Founder / CEO / Managing Director / Other)
Name of Company
What is the company website?
Where is your company headquarters?
What is your annual revenue range
1M - 3M
3M - 10M
10M - 25M
25M+
Number of Full Time Employees (or equivalents)
Which areas of business do you currently oversee?
Strategy and Vision
Operations/Supply Chain
Marketing and Growth
Finance and Cash Flow
People and Leadership
Product/Delivery
What currently feels most complex or heavy in the business?
What decisions are you currently delaying, avoiding or second guessing?
How are you currently making high stakes decisions?
Alone
With a leadership team
With external advisors
Reactively/ As issues arise
Where do you feel least supported as a leader right now?
What tends to create the most internal pressure on you?
Carrying responsibility alone
Growth expectations
Team performance
Cash flow/ Risk exposure
Personal bandwidth/energy
Other
Have you worked with other coaches, consultants or advisors before?
Yes
No
If you answered yes above, please describe what worked and what didn’t.
What are you seeking now that you have not received from previous support?
How do you typically respond to direct, reflective feedback?
I welcome it
I tolerate it, if useful
I prefer gentle guidance
What altruistic, philanthropic or “do good” practices does your company have in place?
If our advisory engagement were successful 12 months from now, what would be different for you?
Which outcomes matter most to you right now?
Clearer decision making
Reduced internal pressure
Stronger leadership presence
Simplified operations
Strategic clarity for next stage
Sustainable growth
This is a private advisory engagement delivered through confidential live sessions and requires a $10,000 USD monthly investment for 12 months. Are you financially prepared for this level of commitment?
Yes
No
I need more context
How do you typically make investments at this level?
Personally
Through the company
With board approval
If we determine there is a strong mutual fit, how soon would you be prepared to begin?
Immediately
Within 30 days
Between 60-90 days
Later this year
Why do you believe now is the right time to engage in this level of support?
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