Client Worksheet

Please complete the form below.


First Name
Last Name
Address (street)
Postal Code
Best Time to Call
If college, what type of degree?
Are you a veteran?
What is your level of education?
If you have a spouse or significant other what is their name?
How involved will they be in your new business?
What are your primary reasons for a possible career change, exploration of business ownership, or investment in a business?
Businesses can operate out of various places. With business ownership, you have control over where you would like to go to work every day. Please tell us your preference from one of the following:  Work From Anywhere, Home Office, Office Space/Building, Retail Location.
Approximate time-line - If you were to decide to own your own business, approximately how soon would you like to begin the operations of this potential new business?
Have you owned any businesses or been self-employed? If yes, please describe.

Have you researched any business ownership options in the past? If yes, please describe.

Please rate your general skills/abilities in the areas listed below:
General Management/Operations
Marketing Strategy
Social Media
Computer Skills
Networking and Relationship Building
Coaching, Consulting, Teaching, Presenting
Hands On Skills (building, fixing, etc.)
Bookkeeping, Accounting, Administrative
When purchasing a franchise or business opportunity there’s no need for prior industry / business experience. In fact, many franchise companies actually prefer no previous experience.  The possibilities are endless. Our goal is to help our clients reinvent themselves and explore many various options. This often means that they will most likely choose an industry / business in which they have no prior experience. In what areas would you like to focus next? Please check off a minimum of five possible “Business Areas of Interest” below.


Understanding that over 50% of franchise units are owned by people who own more than one unit, would you be interested in learning more about: Multiple Units (e.g. The rights to own and manage more than one unit and/or territory within a specified geographic area.)
Available Resources: As your Coach, it's important that I have an understanding of your resources so that I can provide the most relevant advice, coaching and assistance. You can be assured that any financial information you share is always confidential. What would you estimate your total net worth to be (total assets minus total liabilities)? For example: Equity in your home, stocks and bonds, cash on hand, savings, 401K and or retirement fund. Please indicate below your best estimate.

Describe Your 5 Year Goals and Dreams Below:

In 5 years I will no longer need to tolerate:
Describe your INCOME in 5 years:
Describe your LIFESTYLE in 5 years:
How did you hear about me? If radio, what station?