Intake Form

The intake form is designed to capture required information but would hinder strategic and creative thinking at the offsite and onsite portion of the assessment. Please fill out the requested information to the best of your ability.

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Please fill out form to the best of your ability.

First Name

Last Name

Phone Number

Business

Website

Facebook Page

Instagram Page

LinkedIn Page

Business Address

Where do you primarily serve?

Business Category

Who are your competitors in market place?

What do you believe your position is in the category?

Revenue Breakdown

Average Sales of main product in units

Average Price for main product

Typical Profit Margin Made on Sale

Typical Traffic to your website?

What media have you used in the past?