Client Intake Form: Mompreneur Launch System with Mona Ray
Start your small business & spend more time with your kids in just 30 days.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Instagram Handle / Social Media
What is the main thing you want to accomplish in the next 30 days?
What idea are you hoping to build or launch?
*
What does success look like for you after one month?
Do you already have a business name?
Yes
No
I have a few options
Do you already have a logo?
Yes
No
Do you already have a website? If yes, drop the link.
What type of offer are you hoping to create?
Service
Digital Product
Coaching
Other
How many hours per week can you realistically commit?
1-5
5-10
10-15
15-20
What does your childcare / daily schedule look like?
What challenges in your home life do we need to plan around?
What areas do you feel you need the most support with?
Branding
Website
Content
Confidence
All of the above
Are you ready to follow a structured 30-day plan?
What’s your preferred communication style?
What would make you feel supported throughout this process?
Is there anything else I should know about you, your business vision, or your situation?
What motivates you to finish this time?
Begin My Small Business Journey
Should be Empty: