Client Intake and Service Request
Professional intake form for The Impact Consultancy and Write It Out Publishing. Please share your contact details, services needed, project goals, budget, and scheduling preferences.
Contact and Business Information
Full Name
*
First Name
Middle Name
Last Name
Business Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Existing Website URL
How did you hear about us?
Please Select
Google
Social Media
Referral
Existing Client
Other
Project Scope and Service Needs
Services Interested In
*
AI Training/Workshops
AI Business Integration
Website Design
Website Redesign
Graphic Design
Brand Identity Package
Business Systems and Organization
Content Strategy
Publishing Consultation
Book Cover or Layout Design
General Business Consultation
Not Sure - Need Discovery Call
Describe Your Project or Challenge
*
Primary Goal for This Project
Target Deadline
Please Select
Within 30 Days
1-3 Months
3-6 Months
Flexible
Website Type Needed
Business Site
E-Commerce
Artistic Portfolio
Landing Page
Booking Site
Author Site
Not Sure
Graphic Design Needs
Logo
Brand Kit
Business Cards
Social Media Graphics
Book Cover
Flyer
Presentation Deck
Experience, Tools, and Readiness
Current AI experience level
*
Complete Beginner
Some Experience
Use AI Regularly
Want Full Integration
Back-end organization status
*
Very Organized
Somewhat Organized
Needs Work
Starting Fresh
Tools currently using
Budget, Engagement, and Scheduling Preferences
Service Tier Interest
*
Tier 1 Starter Session $150-$300
Tier 2 Project Package $500-$2500
Tier 3 Monthly Retainer $300-$800/month
Not Sure
Budget Range
*
Please Select
Under $250
$250-$500
$500-$1000
$1000-$2500
$2500-$5000
$5000+
Open to Discussion
Preferred Payment Structure
Full Upfront
50-50 Split
Monthly Retainer
Milestone Payments
Best Contact Method
*
Email
Phone/Text
Both
Best Days for Consultation
*
Tuesday Afternoon
Thursday Afternoon
Tuesday - Thursday Evenings
Evenings
Urgency
*
Very Urgent
Moderate
Low - Planning Ahead
Anything Else We Should Know?
Submit
Should be Empty: