Client Residential Assessment

Client Residential Assessment
Welcome to Simplify with Suzanne

Client Intake & Consultation Form

More Time for What Matters Most.

Thank you for your interest in Simplify with Suzanne

I provide personalized household management and personal concierge support designed to help busy individuals and families save time, reduce stress, and simplify everyday life.

This brief form will help me understand your needs before our complimentary 15-minute consulation.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Method of Communication:
Tell Me About Your Needs
What prompted you to reach out to Simplify with Suzanne?
What type of support are you primarily interested in?
Which statement sounds most like you? Check all that apply
How involved would you like for me to be? Check all that apply
How many people live in the home?
Children if so, how many and their ages?
Do you have pets? If so what type and how many?
Which best describes you?

Other
If other, please explain
What services are you looking for?

Other
If other, please explain
What areas feel most overwhelming right now?
If I could remove 3 tasks from your weekly routine, what would they be?
What would make the biggest difference in your daily life right now?
What is Your Preferred Level of Support
How often are you looking for support?
Approximately how much support are you looking for?
Preferred Days
Preferred Time
Is there any other additional information you would like me to know before our consultation?
How did you hear about Simplify with Suzanne?

Other
If other, please explain.
Do you own or manage a business?
Would you like information about my business administrative support services?
What would you most like to delegate?

Other
Should be Empty:

Client Residential Assessment

Tell Me About Your Needs

What is Your Preferred Level of Support