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Business Growth Assessment Intake Form

A business growth assessment intake form for my service and automation.

Name(Required)

First Last

Email(Required)

What is your business name?(Required)

Section 1: Business Foundations

Let's start with some basic information about you and your business.

What industry does your business operate in?

What type of business do you operate? (Select all that apply)(Required)

Service-based

Product-based

E-commerce

Brick-and-mortar

Hybrid model

Other

Please specify other business type

What is your current business structure?(Required)

Sole proprietor

LLC

S-Corp

C-Corp

Partnership

Other

How does your current business structure impact your operations or tax planning?

How long has your business been operating?(Required)

Less than 1 year

1-3 years

3-5 years

5-10 years

10+ years

How many team members/employees do you currently have?(Required)

Just me

1-5 employees/contractors

6-15 employees/contractors

16+ employees/contractors

Section 2: Revenue & Financial Health

These questions will help us understand your business's financial performance.

What is your current annual revenue range?(Required)

$0-$10K

$10K-$25K

$25K-$50K

$50K-$75K

$75K-$100K

$100K-$200K

$200K-$350K

$350K-$500K

$500K+

What is your target revenue for the next 12 months?(Required)

What are your primary revenue streams, and what percentage of total revenue does each contribute?(Required)

Does your business experience seasonal revenue fluctuations?(Required)

Yes, significant seasonal fluctuations

Some seasonality, but fairly stable

No, revenue is consistent throughout the year

Unsure, business is too new to tell

Which months are your high and low periods, and how much do they typically fluctuate?(Required)

What is your current pricing structure, and have you tested different pricing models? If yes, what were the results?(Required)

Include details about fixed price, hourly, subscription models, etc., and any pricing tests you've conducted

What is your average transaction value?(Required)

How frequently do your customers make purchases?(Required)

Do you track your business financials consistently?(Required)

Yes

Somewhat

What is your current profit margin percentage?(Required)

What is your estimated monthly profit?(Required)

Please provide an approximate dollar amount

What percentage of revenue do you reinvest back into the business for growth?(Required)

Less than 5%

5-10%

11-15%

16-25%

26-40%

More than 40%

Varies significantly month to month

How have your profit margins changed in the past 12 months?(Required)

Do you track your financial KPIs regularly? If yes, which ones?(Required)

What are the main causes of your cash flow challenges?(Required)

Are you experiencing cash flow challenges?(Required)

Yes, consistently

Occasionally

Other

What are the main causes of your cash flow challenges?(Required)

Section 3: Customer Acquisition & Sales

Let's learn more about how you acquire and convert customers.

What are your top 3 client/customer acquisition channels, and which one generates the highest ROI?(Required)

What is your current cost to acquire a customer (CAC)?(Required)

Less than $50

$50-$100

$101-$250

$251-$500

$501-$1,000

$1,001-$2,500

$2,501-$5,000

More than $5,000

I don't know/haven't calculated this

What's your best estimate of how much you spend to acquire a new customer?(Required)

What is your conversion rate from lead to paying customer?(Required)

Who is your ideal customer/client? (Demographics, psychographics, pain points)(Required)

Do you have a structured sales process in place?(Required)

	Yes	Somewhat	No
Fully optimized
Needs improvement
No structured process

What's the biggest bottleneck in converting leads to customers?(Required)

Generating qualified leads

Nurturing leads effectively

Closing sales/dealing with objections

Weak follow-up process

Other...

Please specify your bottleneck(Required)

Do you offer payment plans or financing for your products/services?(Required)

Yes

What customer objections do you most frequently encounter regarding your pricing?(Required)

What is your customer retention rate?(Required)

Less than 20%

20-50%

50-80%

80%+

Not sure

What strategies do you use to increase customer lifetime value, and how do you measure success?(Required)

What is your client onboarding process, and how consistently is it followed?(Required)

Describe your process for welcoming and orienting new clients/customers

What CRM or client management system do you use?(Required)

What project/task management tools do you currently use?(Required)

Which aspects of your business are currently automated?(Required)

On a scale of 1-10, how satisfied are you with your current operational efficiency?(Required)

1 Completely Unsatisfied

10 Extremely Satisfied

1 = Completely Unsatisfied, 10 = Extremely Satisfied

What manual processes currently consume the most time in your business?(Required)

Do you have documented SOPs (Standard Operating Procedures)? If yes, for which processes?(Required)

How do you currently track business performance?(Required)

What data points do you regularly review to make business decisions?(Required)

What factors influence your important business decisions? (Select all that apply)(Required)

Financial data/metrics

Industry benchmarks

Personal intuition/gut feeling

Team input/consensus

Customer feedback

Mentor/advisor guidance

Past experience

Market research

Other

Please specify other factors(Required)

Rank your top 3 decision-making factors in order of importance to you:(Required)

From the factors you selected above, which 3 typically carry the most weight in your decision-making process? (Example: 1. Financial data, 2. Customer feedback, 3. Team input)

Section 5: Scalability & Growth Potential

Let's explore your business's ability to scale and grow.

What is your current pricing structure (Fixed price, hourly, subscription, etc.), and how confident are you that it's optimized for profitability?(Required)

What aspects of your business are most difficult to scale?(Required)

Team capacity/hiring

Systems/processes

Technology/infrastructure

Funding/capital

Marketing/lead generation

Product/service delivery

Personal time constraints

Customer support

Other

What resources (team, capital, tech, etc.) would you need to double your business in the next 12 months?(Required)

Have you set specific growth targets for the next 1-3 years?(Required)

Yes, detailed targets with metrics

Yes, general targets

No, but I have a general vision

No, I haven't set specific targets

Please share your key growth targets (revenue, team size, market expansion, etc.)(Required)

Have you documented your core business processes? If yes, which ones?(Required)

What technology investments are you considering to support growth?(Required)

What sustainable competitive advantage do you have that competitors cannot easily replicate?(Required)

Consider your unique strengths, proprietary methods, team expertise, etc.

What are your top 3 current business challenges preventing growth?(Required)

Please be specific about the challenges and their impact

On a scale of 1-10, how much of your time is spent working IN the business vs. ON the business?(Required)

1 - Almost entirely working IN the business

10 - Almost entirely working ON the business

What skills or expertise gaps exist in your current team?(Required)

What aspects of business growth feel most uncomfortable or challenging to you personally?(Required)

Consider mindset barriers, risk tolerance, delegation challenges, etc.

Section 7: Offer Positioning & Competitor Analysis

Let's analyze your market position and competitive landscape.

What makes your product/service unique in the marketplace?(Required)

Who are your top 3 competitors?(Required)

How do your offers compare to competitors?(Required)

	Lower than competitors	Similar to competitors	Higher than competitors
Price
Value
Delivery
Results

Section 8: Desired Business Outcomes

Finally, let's discuss what you hope to achieve from this Business Growth Assessment.

What specific outcomes do you hope to achieve from this Business Growth Assessment?(Required)

Are you primarily seeking:(Required)

Quick wins to implement immediately

Medium-term strategic improvements

Long-term transformational growth plan

All of the above

What would a successful implementation of our recommendations look like for you in:(Required)

Please provide your vision for success at each time interval

30 days:(Required)

90 days:(Required)

6 months:(Required)

Which area of your business would you most like to see improved as a result of this assessment?(Required)

What previous business growth solutions have you tried, and what were the results?(Required)

What specific growth strategies have you previously tried that didn't work as expected, and why do you think they failed?(Required)

Is there anything else you'd like us to know about your business that would help us provide more targeted recommendations?(Required)

“I was very impressed and overwhelmed by how Sean exceeded my expectations of helping refresh my brand and zero in on the ideal clientele I’d like to see coming to my business.”

Bryan Butas

Owner, B's Carpet Cleaning

“Sean is very informative and walks you through every step of the process. If you need anything media wise I suggest you use Majority Media!!!”

Keith Logan

Owner , Quality Finishes Painting

Working with Majority Media was an experience in itself. It made me feel more confident in starting my business and better prepare me to be the best business owner that I can be. I recommend to anyone who wants to have a successful business

Mikha'el Singletary

Owner, Scarred Love

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Contact

Phone

(917)-633-5100

Email

sean@majority.media