Client Intake Form | Inspired Growth

Business Growth & Operational Support Program

Client Intake & Discovery

Help us understand your business so we can tailor our support specifically to your needs. Takes about 10–15 minutes.

✦ All responses are strictly confidential

Business Overview

Tell us about your business

Legal Business Name *

Industry / Business Type *

Business Location

Years in Operation

Primary Website

Social Media Handle(s)

Business Stage

Start-UpGrowthScalingEstablished

Registration Status

RegisteredSole TraderPartnershipOther

Business Overview *

Services & Offers

What you offer and who you serve

Primary Services or Offers *

Ideal Client Profile *

What Makes You Unique? *

Pricing Structure

PackagesRetainersOne-TimeCustom

Average Price Range

Business Performance

Current numbers and patterns

Avg. Clients / Sales Per Month

Inquiries Per Month

Est. Conversion Rate

Sales Patterns / Seasonality

Busiest Months / Seasons

Slowest Months / Seasons

Lead Generation & Marketing

How clients find you

Primary Lead Sources (select all that apply)

ReferralsInstagramFacebookLinkedInPaid AdsWebsite / SEONetworkingPodcast / SpeakingTikTokEmail List

Best-Performing Platform

Currently Running Paid Ads?

YesNo

Lead Generation Challenges *

Sales & Conversion Process

How you turn inquiries into clients

Inquiry-to-Client Process *

How Do You Respond to Inquiries?

Manual MessagesEmail TemplatesCRM / AutomationPhone / Video Call

Formal Follow-Up Process?

YesNoInformal

Where Are Potential Clients Lost? *

Pricing & Positioning

How you communicate your value

Client Feedback on Your Pricing

Too HighToo LowJust RightMixed

Confidence Communicating Value

Very ConfidentSomewhatNot Confident

Please Elaborate

Systems & Operations

How your business runs day-to-day

Task & Lead Organization

CRM SoftwareSpreadsheetsPaper / ManualProject Mgmt Tool

Payment Collection

StripePayPalBank TransferWiseInvoice Platform

Software & Tools in Use

Most Disorganized / Inefficient Area *

Challenges & Bottlenecks

What's holding your business back

Primary Challenge Limiting Growth *

What Have You Already Tried?

What Didn't Work?

Goals & Desired Outcomes

Where you want to go

Goals for the Next 3–6 Months *

What Would Make This a Success? *

Priority Support Areas (top 3)

Lead GenerationSystems & AutomationSales & ConversionPricing & PositioningTeam / DelegationMarketing StrategyClient Experience

Commitment & Readiness

Your capacity to implement

Hours Available Per Week

1–2 hrs3–5 hrs5–10 hrs10+ hrs

Ready to Invest in Tools if Needed?

YesNoOpen to It

Commitment Level *

1 = Not yet committed · 10 = Fully committed and ready to act

1 2 3 4 5 6 7 8 9 10

Not committedFully committed

Anything That May Affect Participation?

Consent & Authorization

Entirely voluntary — your choice

Willing to provide ongoing feedback? *

YesNoOpen to It

Open to tracking and sharing measurable results? *

YesNoOpen to It

Willing to provide a written testimonial? *

YesNoOpen to It

Open to a video testimonial?

YesNoOpen to It

Consent to anonymized case study use?

YesNoOpen to It

Consent to results referenced in marketing with your name?

YesNoOpen to It

Declaration

By submitting this form, I confirm that all information provided is accurate and complete, that I understand recommendations are based on this information, and that I agree to engage in good faith. I acknowledge that results depend on individual effort and implementation.

Full Name *

Business Name *

Email Address *

Date

✦

Thank You

Your intake form has been received and saved. Jillian will review your responses and be in touch ahead of your first session.

What Happens NextYour responses will be reviewed in full before we meet. Please retain a copy of your answers for your records.