LaunchPad Intake Questionnaire
Pre-Program Client Assessment
Basic Information
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Profession
*
Employment Status
*
Employed full-time
Employed part-time
Self-employed
Unemployed
Student
Other
Business Stage & Transition
Which stage best describes your business?
*
Idea only
Planning phase
Recently launched
Operating (1-3 years)
Other
Are you transitioning from employment to entrepreneurship?
*
Yes, planning to transition soon
Yes, already transitioned
No, not planning to transition
If you’ve started, how long have you been operating?
What made you decide to go into business for yourself?
Business Idea & Audience
Briefly describe your business idea or current business.
*
What services or products do you offer (or plan to offer)?
*
Who is your ideal client?
What problem are you solving?
How confident are you in your business idea?
Not confident
1
2
3
4
5
6
7
8
9
Very Confident
10
1 is Not confident, 10 is Very Confident
Clarity, Challenges & Strategy Gaps
How clear are you on your business direction?
*
Not clear
1
2
3
4
5
6
7
8
9
Very clear
10
1 is Not clear, 10 is Very clear
What are your biggest current challenges?
*
Where do you feel you have strategy gaps?
Business planning
Marketing
Sales
Legal setup
Finance
Operations
Other
What do you currently have in place?
Defined niche
Pricing structure
Business name
Business plan
None
What do you feel most unclear about right now?
Legal Readiness
Have you registered your business?
*
Yes
No
In progress
What is your current or planned business structure?
Sole proprietorship
Partnership
LLC/Company
Not sure
Do you have contracts/terms/policies in place?
Yes
No
In progress
How concerned are you about legal risks?
Stressed
1
2
3
4
5
6
7
8
9
Not Concerned
10
1 is Stressed, 10 is Not Concerned
Financial Position & Pricing Confidence
How confident do you feel about setting and communicating your prices?
*
Not confident
1
2
3
4
5
6
7
8
9
Very confident
10
1 is Not confident, 10 is Very confident
Why?
Have you started charging for your services?
Yes
No
If yes, what is your price range?
Income goal for the next 6 months
Marketing & Client Acquisition
Do you currently market your services? If yes, how?
Do you have an online presence?
Instagram
Website
LinkedIn
None
Describe your biggest marketing or client acquisition challenge.
Mindset, Fears & Confidence
How confident do you feel about launching or growing your business?
*
Not confident
1
2
3
4
5
6
7
8
9
Very confident
10
1 is Not confident, 10 is Very confident
What fears or doubts are keeping you back?
What does success look like to you?
Goals & Expectations
What would make this program a success for you?
*
What are your top three business goals for the next 3 months?
*
What support are you looking for?
Commitment & Readiness
How committed are you to taking action and implementing what you learn?
*
Not committed
1
2
3
4
5
6
7
8
9
Fully committed
10
1 is Not committed, 10 is Fully committed
Is there anything that might prevent you from fully participating in the program?
How much time can you commit weekly?
Are you ready to take action and implement weekly tasks?
yes
no
Why is now the right time for you?
Submit
Should be Empty: