*Client Name
*Business Name
*Email
*Telephone
*What do you sell?
*On average how much do you earn per new client?
*Who is your ideal prospect?
*Do you have desire to be a coach, author, speaker, or trainer?
Yes  
No  
*10 being perfect, 1 being in dire straits, rate the following on where you are currently on a scale of 1-10:
*Lead Generation
*Online Marketing Efforts
*New Client Acquisition
*Income
*Referrals
*Client Retention
*List 3 GOALS that your business must accomplish in the next year
*What would accomplishing these goals mean to you and your life?
*What things have prevented you from achieving your goals?
*What would the consequences be if these things don't change?