New Client Intake Form – Fearless Impact

It is with great gratitude we welcome you to The Fearless Impact Family. We are honored you've chosen to partner with us and we are looking forward to creating a prosperous relationship.

The following intake form it's designed to give us a snapshot of where your business is now so we can best determine how to get you where you want to go. This form is critical for our onboarding call and should be completed no less than 48 hours prior to our session. We are not able to do the onboarding without it.

They are over 70 questions, so please allot for at least 2.5 hours to complete it thoroughly and honestly. None of the information will be shared outside of our organization - it is strictly confidential - so we encourage you to be as honest as possible with your answers.

Due to the length of the form, we recognize it may take several settings to complete it. You can "save your work" by clicking the "save and the continue later" link at the bottom of each page.

VERY VERY IMPORTANT:
Please be sure to click SUBMIT at the end of questionnaire - not “save and continue”. We will NOT receive your information until you click the submit button.

Additionally, you will receive a copy of all your answers immediately upon submission. If you do not get the email, please check your spam. If it's not there, please contact us to ensure we received your information.

Thank you again, and we look forward to working with you

Basic Information

Your Name(Required)

First Last

Phone Number

Business Name(Required)

Email(Required)

Main Website

Additional Website

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

List all social accounts URLS and following (connections, followers, etc)(Required)

Company Data

Industry(Required)

How long have you been in business?(Required)

Describe your company’s general infrastructure? (For example, “I own the business but I’m never there, and I defer to my manager.”) Explain whether it’s hands on, hands off, who runs things, political environment, partners, managers, decision makers, etc.(Required)

How many employees?(Required)

How many combined years of expertise do your leadership/employees have?(Required)

Locale/Service Area(Required)

Micro-Local (Cleaners, etc)

Local (Metro Area)

Regional

National

International

How many locations?(Required)

Why did you start the business?(Required)

How satisfied are you with the results of your business?(Required)

Please enter a number from 1 to 10.

Rank 1 to 10 (10 highest)

Why?

Do you have a business plan?(Required)

Yes

No

Are you following it/on target?(Required)

Yes

No

What do you feel is off target?

Who You Are/What You Do (products/services)

Describe what you do(Required)

Describe what you do in 10 words or less(Required)

What is different about the product or service that you offer?(Required)

List the BENEFITS of the service you provide or products you sell. Focus on the BENEFITS, not the features: (i.e. Automobile Feature: Air Conditioning - Benefit: cool, comfortable ride)(Required)

Competition

List 3 competitors:(businesses who offer similar services in the same proximity and could possibly have the same customers as you)

Competitor #1:(Required)

Competitor #2:(Required)

Competitor #3:

What are your competitor’s biggest failings/short comings?

Competitor #1 (failings):(Required)

Competitor #2 (failings):(Required)

Competitor #3 (failings):

What do they do that you don't or wish you could?(Required)

What assets, intellectual property, patents, licenses, certifications, etc that your competitors don't?(Required)

Is there a process or a way of doing things that is different that your competitors?(Required)

Have you tried putting a new spin on an old idea or do something different than the industry norm or done anything to stand out from your competition?(Required)

What are the top 2-3 reasons prospects DON'T buy from you?(Required)

Audience/Target Market

Who is your target market?

Who do you PRIMARILY service?

Businesses (B-to-B)

Consumers (B-to-C)

Business Professionals (B-to-P)

List top level business demographics(Required)

List top level Consumer/Professional demographics(Required)

How would you appeal to your target audience? (Why would they like you/your service)(Required)

Is your target market ACTIVELY LOOKING for your services? How do they search?(Required)

What do your customers really want… from their point of view? (Be specific. Don’t just answer a “quality product,” “low prices,” or “outstanding service.”)(Required)

What are your target market's concerns, fears, issues, challenges?(Required)

How do your products/services solve those wants for your customers or address their fears and concerns?(Required)

Existing Customers

How many existing clients do you have?(Required)

Have you ever asked a new client why they chose you? What was their answer?(Required)

What makes your company memorable? Why do customers return?(Required)

What do customers say about your company? [ask about the Big Ass Fans example](Required)

Do you have your current customers in a computer database?(Required)

Yes

No

Are they segmented into groups with similar buying habits/patterns?(Required)

Yes

No

Do you keep in touch with them on a regular basis?(Required)

Yes

No

How often per year?(Required)

When was the last time you contacted them? Why?(Required)

Do you regularly solicit current/past customers to buy from you again? If so, how? If not, why not?(Required)

Personal Goals

What are your personal financial goals for your business for the next 12 months? (how much would you like to earn personally?) Note: If your personal income is not directly impacted by the revenue of the company (i.e. you work for a corporation, etc, put "N/A")(Required)

How many hours would you like to work per day?(Required)

How many hours are you working per day now?(Required)

How many days per week would you like to work?(Required)

How many days per week are you working now?(Required)

Top Level Financial Goals

In the next 3 months...

New customers (3mo):

Gross Sales (3mo):

New Profit (3mo):

In the next 12 months...

New customers (12mo):

Gross Sales (12mo):

New Profit (12mo):

5F Philosophy

We believe that any area of your life impacts all areas of your life. Our goal is to bring value to all areas of your life through creating a business that supports your lifestyle, vice-versa. The 5f Section is optional, but we strongly encourage you to complete this section to allow us to provide the most value to you.

Please rank the level of satisfaction in each area of your life on a scale of 1 to 10 (10-highest)If you'd care to share 'why' you've given each area the ranking you did, please feel free to do so.

Faith

Family(Friends)

Fitness

Finance

Fun

Scale of 1-10 (10 is highest)

Comments

Personality

To provide the highest level of support, it's imperative that we know 'who you are'. The following personality test is a very quick, yet accurate assessment of your personality traits. Please visit https://16personalities.com to complete the assessment. Not only does it help up support you, you may also uncover things about yourself that you may have not known.

Enter your letters and type descriptor:(Required)

The Numbers

What monthly gross revenue is your business currently generating?(Required)

What is your total monthly expenditure?

Breakdown your current business monthly expenses? (payroll, rent, etc.)

Expense #1

Expense #1 Amount

Expense #2

Expense #2 Amount

Expense #3

Expense #3 Amount

Expense #4

Expense #4 Amount

Expense #5

Expense #5 Amount

Expense #6

Expense #6 Amount

Expense #7

Expense #7 Amount

Expense #8

Expense #8 Amount

Expense #9

Expense #9 Amount

Expense #10

Expense #10 Amount

List other expenses

Customer Value

What is the ANNUAL value of a customer? (How much do you earn from the average customer ANNUALLY?)(Required)

What is the LIFETIME value of a customer? (How much do you typically earn TOTAL from the average customer?)(Required)

What is the average profit margin per customer?(Required)

How many new clients can you feasibly service per year?(Required)

How is your money collected? (immediate check, immediate credit, net-terms, invoicing, electronically online, retainer, etc.)(Required)

Current Marketing

CAC = Customer Acquisition Cost (How much does it cost to acquire a new client using the method listed - (If you run an ad that costs $1,000 and you acquire two new customers, your Cost of Acquisition is $500.)

CR = Conversion Rate (Out of X leads, Y become paying customers)

List the methods are you currently using to generate business? List the percentage of business each method generates.

METHOD

%

C A C

CR

Of the list above, what is your biggest and best source of new business?(Required)

Does your company have a marketing budget? If so, specify (how did you come to this number?)(Required)

How many formalized, referral generating systems do you have working right now that everyone in your company with who interacts with your customers uses and follows?(Required)

Do you offer “packages” or “bundles” of one or more complimentary products to customers making a purchase? If so, how does the system work?(Required)

Do you know what your attrition rate is and why clients stop buying from you?(Required)

Verticals

What other products/services complement your offering? What does your offering complement?(Required)

What happens with your clients immediately before and after buying your products/services? (Do they buy anything from another business before coming to you? What decisions are typically made?)(Required)

Who else benefits from your success; excluding your customers, your employees and your family members? How many of your suppliers would be motivated to help you grow your business more because it will directly benefit them at a very high level?(Required)

When you create a new customer for your business or profession, who else have you indirectly created a new customer for?(Required)

Who is in a position to refer customers to your business?(Required)

Brand/USP Discovery

Why do people buy from you?(Required)

If they aren’t buying from you now, why should they?(Required)

Make a prioritized list of the services or products most desired by your clients. Put a star by the ones you can fulfill.

Supplementary Questions

How would an industry professional finish this statement about your company: "Yes, I've heard of [YOUR COMPANY], they're great at ________________ ."

Is there a process or a way of doing things that is different that your competitors?

Have you tried putting a new spin on an old idea or do something different than the industry norm?

Does your company use any type of tagline or slogan?

What do you want people to think about when they hear your company name? (i.e. when you think of Apple, you think of innovation and user experience. When you think of Publix, you think of a great shopping experience) Be specific as possible. Avoid generalities like "customer service, integrity, excellence", etc

Abstract

If you had to choose a color to describe your business, what would it be?

If your company was a person would you consider it male or female? (not considering the employees or customers, but the company itself)

If your company had a personality, what would it be?

How do you feel when you think about your business (when you're not doing your business)?

Summary

After answering the previously listed questions try to consolidate all of your thoughts into several sentences.(Required)

Fearless ImpactClient Intake Form