Business Consulting > Client Intake Form

Please fill out this form completely.

Name*
First Last
Website (f you have one)
What type of business do you have/ What type of health professional are you?*
Is your business active (ie, are you actively seeing clients), or are you just getting started?*
What are the core problems your business solves (ie, your niche)*
Who are your ideal clients? (women? men? people with hashimotos? people with diabetes?)*
In what capacity are you, or are you wanting to work with clients: online/offline? Group programs? Private Coaching? A Combination? Please describe.*
What is currently you holding you back from having the business you want?*
What are 3 things you'd like to accomplish in our session, or, if you've chosen a package of sessions, over the course of our working together?*