JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Business Background Questionnaire
To qualify for a Complementary Business Coaching Session with Hein Kruger, ActionCOACH
Note: This is completely confidential and will not be shared to anyone.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Please complete this questionnaire to the best of your ability.
This questionnaire is designed:
1) to help me determine if there is a good fit between you and your business goals and my coaching services
2) to help make our initial coaching session as productive as possible.
1. CLIENT DETAILS:
Client Name
*
Your answer
Business Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Location (Province / Country)
*
Your answer
2. YOUR BUSINESS:
Who, other than yourself, is involved in the DECISION making of your business?
*
Your answer
What type of INDUSTRY are you in?
Your answer
List the types of products and/or services you provide for your customers.
Your answer
How long have you been in business?
Your answer
How did you acquire this business?
Started
Franchised
Bought existing
Inherited
Other
Clear selection
Describe your main challenges.
*
What holds you back? Be specific.
Your answer
How many hours per week do you currently work on average? & how do you feel about this?
Your answer
3. YOUR MARKETING:
What makes you unique?
Why would a customer buy from you and not your competition?
Your answer
How do you generate leads for your business?
Radio
Daily Newspaper
Local paper
Television
Telemarketing
Direct Mail
Catalogues
Face to face calling
Referals
Flyers
Magazine adverts
Walk - Ins
Social Media
Online advertising
Other:
Please provide estimated percentages for your leads.
For Example: 80% leads come from Social Media, 7% from flyers etc
Your answer
What is your conversion rate?
I.e: what % of leads actually buy from you?
Your answer
Is your conversion rate estimated or measured?
Estimated
Measured
4. YOUR SALES GOALS:
Reminder: This is completely confidential and will not be shared to anyone.
What revenues and profits has your business generated in the past 3 years and what do you project for the current year?
Please put Projected, Revenue and Profit - If you do not have 3 years history, just include the years you do have.
Your answer
What percentage growth do you expect to see in the next 12 months?
Your answer
How do you see this growth being achieved?
Your answer
5. YOURSELF AS A BUSINESS OWNER:
What percentage of your time, on average do you devote to the following activities?
Strategic Planning?
% of time
Your answer
Business Development and Marketing
% of time
Your answer
Day-to-day Operational and Tactical Requirements
% of time
Your answer
Trouble-shooting and Fighting Fires
% of time
Your answer
% of time on other activities
Please explain
Your answer
Describe your strengths as a business owner
Your answer
Select the areas you need to improve on as a business owner
Leadership
Marketing
Sales
Finance
Operations
Strategic Planning
Goal Setting
Customer Service
Decision Making
Employee Development
Other:
Expand on the areas where you need improvement as a business owner
Your answer
What frustrates you with your business?
*
Your answer
What are your hobbies? How do you spend time outside of your business?
Your answer
If you had enough time and financial resources to do anything you choose, how would you spend your time outside of your business?
Your answer
Which statement best describes you?
I’m an action oriented person who is most comfortable when in charge.
I’m a ‘people’ person who values friendships in my work relationships and likes to build consensus.
I’m calm and cool under pressure and like to make logical rather than emotional decisions.
I like to study lots of information before making decisions.
Clear selection
6. YOUR TEAM:
How many employees, on average, have you employed in the past 3 years?
Current employees and Past employees
Your answer
What team or staff challenges are you currently facing on a regular basis?
Your answer
If you could make any changes to your team, what would they be and why?
Your answer
7. COACH-ABILITY:
If there was one thing you could change about your business in the next 90 days, what would it be and why?
Your answer
Is there any additional information you feel would be valuable for our discussion?
Your answer
Please share you social media links with us so we can follow you !
Facebook, LinkedIn, Instagram, Website link etc
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
