Needs Assessment for Your Business Breakthrough Strategy Session

I really love helping people, but because of the demand for my program there only a few spots open per month. This questionnaire helps me understand if you’d be able to apply the strategies I’ve used with my most successful clients.

If you would like to consider my Business Breakthrough Coaching Program for service based business owners to take your marketing to the next levelplease fill out the application form below.

In this session, I’ll learn about you, your business, your current situation, goals, and challenges. Then I’ll explain in more depth how we’ll work together and answer any of your questions. If we decide there’s a good fit, we’ll move forward and set up our first one-on-one session.

Of course, if you feel this approach is not for you, you won’t get any pressure to move forward.

Your Name (required)



Field/Industry (required)

Your Email (required)

Your Phone Number (required)

Your Time Zone (required)
Eastern Standard TimeCentral Standard TimeMountain Standard TimePacific Standard Time

How did you find out about my company?
WebinarWeb SurfingFacebookTwitterLinkedInOnline DirectoryReferralOther

If Other please say how you found me.

If referred, name of person who referred you.

Intentions and Goals

What is the business you're in? Who are your clients and what kind of results do you produce for them? Please give as much detail as possible.

Please tell me, in as much detail as possible what you would like to accomplish with your marketing in the upcoming year. And what specifically do you want to get out of my Business Breakthrough Coaching Program.

How is your product / service offering different from your competitors?

What marketing materials do you have to promote your business?

What marketing mediums do you use and how much do you spend?

Would you describe these marketing mediums as effective in reaching your core target market?

What is the most profitable aspect of your business?

What is your average sales value per transaction?

What is your average gross profit % per transaction?

How many enquiries do you get per day / week / month?

Your Current Monthly Revenue:

Your Monthly Revenue Goal: How much do you want to increase your revenue within 12 months?

What is one ideal client worth to you?

What do you think might be slowing you down, stand in your way or stopping you from reaching your goals?

Do you have a website? If so what is the URL?

Where else are you investing for marketing and selling support?

On a scale of 1-10 (10 being highest), how important is your need for structure and support?

How WILLING are you to invest the time, money, and resources to grow your business? (1-10)

How COMMITTED are you to invest the time, money, and resources to grow your business? (1-10)

How ABLE are you to invest the time, money, and resources to grow your business? (1-10)

In reviewing my website ( why do you feel we may be a good fit?

Assuming we are a good fit, are you ready to get started right away?

If you are chosen for a Business Breakthrough Strategy Session do you commit to calling at your scheduled time?
Yes I will be promptNo I can't promise for sure


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