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Client Intake Questionnaire
Intake Questionnaire
Please fill in your missing information (if any) and select the preference you would like to update. You do not have to answer each question. If you wish to just change your email address, click the checkbox right above the Update button, and we will send you a link to do that.
Numbers
How much traffic do you get each month?
How many new leads do you get each month?
How many new customers do you get each month?
How many customers do you have right now?
What is your current monthly revenue?
What is your monthly revenue goal in the next 6 months?
How do you envision that being accomplished?
What is yor average product price?
MARKETING
What’s your biggest problem to solve (in terms of marketing)?
How do you currently generate leads?
What are your lead sources?
How do you currently follow up with those leads?
Average CTR
Do you have any partners that refer to you?
Do you have any up-sell items?
How many contacts do you have on your email list?
What are your biggest frustrations / pain points?
Where do you think your biggest/best opportunity is?
FUTURE/IDEAS
What is the direction you want your business to take?
What do you consider to be success in your business?
Do you have ideas for future products/premiers?
PRIORITIES
What are your top priorities in getting started with CCJ?
Are there any specific tasks you do daily, you want to automate?
Is there anything else you’d like to tell us?
VITALS
First Name *
Primary Email *
Facebook *
Facebook Group
Facebook Page URL
Instagram *
YouTube *
Pinterest *
LinkedIn *
Cell Phone *
Business Phone *
Business Website
Company *
Blog URL *
Additional Applications Used (Zapier, Zoom, Paypal, Calendly)
Your Time Zone
Please select one
EST
CST
MST
PST
Your Mailing Address *
Optin Page URL
Submit
