Client Intake

1
Full Name* This field is required.
First Name
Last Name
2
Email Address* This field is required.
example@example.com
3
Phone Number* This field is required.
Please enter a valid phone number.
4
Age* This field is required.
5
What city and state are you based in?* This field is required.
6
How did you hear about me?
7
Select which of the following apply to you
Father
Mother
Grandfather
Grandmother
Sister
Brother
Uncle
Aunt
Married
Divorced
Single
It's complicated
8
What would you like to achieve by working with me as your coach?
I want to grow and expand my business or career
I want to grow and evolve personally with mindset coaching
I want both business expansion and personal growth
9
What best describes you?
Musician
Singer
DJ
Speaker
Artist
Other
10
Your Business* This field is required.
11
How long have you been operating professionally?* This field is required.
12
Website & Socials* This field is required.
13
What services do you currently offer?* This field is required.
Weddings
Corporate Events
Restaurants
Clubs
Private Parties
Tours
Lessons
Online Content
14
Annual Revenue* This field is required.
Please Select
Please Select
Under $25,000
$25,000–$50,000
$50,000–$100,000
Over $100,000
15
Average Booking Price* This field is required.
Please Select
Please Select
Under $500
$500–$1,000
$1,000–$2,500
$2,500-$5,000
Over $5,000
16
Desired Average Booking Price* This field is required.
Please Select
Please Select
Under $500
$500–$1,000
$1,000–$2,500
$2,500-$5,000
Over $5,000
17
How many paid performances per month?* This field is required.
18
Areas That Need Help* This field is required.
Branding
Pricing
Website
Social Media
Marketing
Sales
Lead Generation
Client Experience
Business Systems
Automation
Luxury Positioning
Scaling
Content Strategy
Personal Brand
Offer Creation
19
Business Goals* This field is required.
Raise my prices
Book higher-paying clients
Increase monthly income
Improve my online presence
Build a luxury brand
Create better systems
Expand my services
20
Platforms you actively post on* This field is required.
Instagram
Facebook
TikTok
YouTube
LinkedIn
21
How often do you post?* This field is required.
Multiple times a day
Daily
A few times a week
Weekly
A few times a month
Rarely
Not currently posting
22
What is your biggest challenge with social media?* This field is required.
23
If we worked together over the next 30 days, what would you love to be different?
24
What is the single biggest problem you'd like to resolve in your business over the next 12 months?* This field is required.
25
How satisfied are you with your life overall right now?
1
2
3
4
5
6
7
8
9
10
Not at all satisfied
Very satisfied
26
Which areas of life would you most like to improve?
Confidence
Purpose
Relationships
Discipline
Emotional health
Stress
Motivation
Self-worth
Career
Finances
Spiritual growth
Work-life balance
Leadership
Habits
Decision-making
Limiting Beliefs
Manifesting Properly
Other
27
What is the biggest challenge you're currently facing?
28
Imagine it's one year from today. What's happening in your life that tells you you've become the person you want to be?
29
What do you believe has been keeping you from making that progress?
30
Have you worked with a coach, therapist, mentors, or personal development program before?* This field is required.
Yes
No
31
How committed are you to creating change in your life?* This field is required.
1
2
3
4
5
6
7
8
9
10
1
10
32
What's one new habit or mindset you'd like to build?
33
What's one habit or pattern you'd most like to break?
34
What level of investment are you willing to make for your business?* This field is required.
Under $500
$500–$1,500
$1,500–$3,000
$3,000–$5,000
$5,000+
35
When would you like to begin?* This field is required.
ASAP
Within two weeks
Within a month
Just Exploring
36
Is there anything else you'd like me to know before our call?
Should be Empty: