Section 1: Personal and Business Background

Email: *

Phone *

Business Name: *

Position / Role in the Business: *

Industry / Field: *

Briefly describe your business and the services / products you offer: *

Section 2: Current Business Status

What are the current challenges you are facing in your business? (Select all that apply) *

What areas of your business are you looking to improve? (Select all that apply) *

What is your primary reason for seeking help with your business right now? *

What have you tried so far to address these challenges? *

Section 3: Self Awareness and Personal Growth

On a scale of 1-10, how would you rate your current level of self-awareness? *

Have you engaged in any personal development practices before? *

No

Other...

What are your personal growth goals for the next 12 months? *

How do you believe personal growth and self-awareness can impact your business? *

Section 4: Expectations and Goals

What are your expectations from our work together? *

Clear strategic direction and action plan

Increased profitability and growth

Improved business systems and processes

Personal empowerment and leadership development

Support through business transitions (e.g. sale, merger)

Other...

How would you define success at the end of our engagement? *

Business achieving specific financial goals

Streamlined operations and improved efficiency

Personal satisfaction and fulfillment

Sustainable business model and strategy

Successful sale or exit strategy

Other...

What is the most significant change you want to see in your business or personal life as a result of our collaboration? *

Are there any specific tools, methods, or approaches you would like us to incorporate in our work together? *

Section 5: Additional Information

Is there anything else you would like us to know about your business or personal journey that will help us support you better? *

Preferred method of communication: *

Email

Phone

Zoom / Video Call