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Application for Chat – Page 2

Please tell me a little about your business. Who is your target market? What kind of product/service do you provide? How long have you been in business?

What was your business revenue over the last 12 months?

When it comes to your business overall, what are the 3 biggest challenges you are facing at this time?

When it comes to your team/employees, what are the 3 biggest challenges you are experiencing?

On a scale of 1-10 (10 being highest), how urgently important is it for you to get these solved... and why?

Are you willing to invest a reasonable about of time, energy and/or money to solve the issues you've referenced above?

What resources or support have you sought up this point to help you solve these challenges?
(e.g., worked with a coach or consultant, read any books, invested in training, etc)

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Last Name:

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Address:

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City:

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How you heard about us:

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What Clients Say…

Since working with you, Sabrina, we made more money in the last month than we’ve made in any single month–EVER! What we’re doing with you works!

Debbie Pierce, LPC, NCC, EAP 2
Gaits of Change Counseling Center