BUSINESS HEALTH ASSESSMENT
Do You Need a Success Prescription?
Name:
First Name
Last Name
Business Name:
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
1. What best describes your business? Startup (0-1 year) / Growing (1-3 years) / Established (3-5 years) / Scaling (5+ years)
Startup (0-1 year)
Growing (1-3 years)
Established (3-5 years)
Scaling (5+ years)
2. What is your current business structure? Sole Proprietor / LLC / S-Corporation / C-Corporation / Partnership / Not Sure
Sole Proprietor
LLC
S-Corporation
C-Corporation
Partnership
Not Sure
3. Approximately how much revenue did your business generate in the last 12 months? Under $50,000 / $50,000-$100,000 / $100,000-$250,000 / $250,000-$500,000 / $500,000+
Under $50,000
$50,000-$100,000
$100,000-$250,000
$250,000-$500,000
$500,000+
4. Do you currently have a tax strategy designed specifically for your business? Yes / No / Not Sure
Yes
No
Not Sure
5. When was the last time you met with a tax professional to proactively plan for taxes? Within 3 months / Within 1 year / More than 1 year ago / Never
Within 3 months
Within 1 year
More than 1 year ago
Never
6. Do you currently owe the IRS or State Tax Agency? No / Less than $10,000 / $10,000-$25,000 / $25,000-$50,000 / $50,000+
No
Less than $10,000
$10,000-$25,000
$25,000-$50,000
$50,000+
7. Are all of your tax returns currently filed? Yes / No / Not Sure
Yes
No
Not Sure
8. Which areas need the most attention in your business right now? Business Structure, Tax Planning, Tax Debt Resolution, Bookkeeping, Payroll, Business Credit, Cash Flow, Compliance, Scaling & Growth Strategy
Business Structure
Tax Planning
Tax Debt Resolution
Bookkeeping
Payroll
Business Credit
Cash Flow
Compliance
Scaling & Growth Strategy
9. Have you ever been told whether an S-Corp election could save you money? Yes / No / Not Sure
Yes
No
Not Sure
10. If we found opportunities to improve your structure, reduce taxes, or strengthen your business foundation, would you be interested in a Business Buildout Strategy Session? Yes / Maybe / No
Yes
Maybe
No
BONUS QUESTION: What is the biggest challenge currently holding your business back?
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