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New Client Intake Questionnaire
Step
1
of
18
5%
It is with great gratitude we welcome you to the Money Mouth Marketing Family. We are honored you've chosen to partner with us and we are looking forward to creating a prosperous relationship.
The following intake form it's designed to give us a snapshot of where your business is now so we can best determine how to get you where you want to go. This form is critical for our onboarding call and should be completed no less than
48 hours prior to our session
. We are not able to do the onboarding without it.
They are over 70 questions, so please allot for at least 2.5 hours to complete it thoroughly and honestly. None of the information will be shared outside of our organization - it is strictly confidential - so we encourage you to be as honest as possible with your answers.
Due to the length of the form, we recognize it may take several sittings to complete it. You can "save your work" by clicking the "save and the continue later" link at the bottom of each page.
VERY VERY IMPORTANT:
Please be sure to click SUBMIT at the end of questionnaire - not “save and continue”. We will NOT receive your information until you click the submit button.
Additionally, you will receive a copy of all your answers immediately upon submission. If you do not get the email, please check your spam. If it's not there, please contact us to ensure we received your information.
Thank you again, and we look forward to working with you
Basic Information
Your Name
(Required)
First
Last
Phone Number
Business Name
(Required)
Email
(Required)
Main Website
Additional Website
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
List all social accounts URLS and following (connections, followers, etc)
(Required)
Company Data
Industry
(Required)
How long have you been in business?
(Required)
Describe your company’s general infrastructure? (For example, “I own the business but I’m never there, and I defer to my manager.”) Explain whether it’s hands on, hands off, who runs things, political environment, partners, managers, decision makers, etc.
(Required)
How many employees?
(Required)
How many combined years of expertise do your leadership/employees have?
(Required)
Locale/Service Area
(Required)
Micro-Local (Cleaners, etc)
Local (Metro Area)
Regional
National
International
How many locations?
(Required)
Why did you start the business?
(Required)
How satisfied are you with the results of your business?
(Required)
Please enter a number from
1
to
10
.
Rank 1 to 10 (10 highest)
Why?
Do you have a business plan?
(Required)
Yes
No
Are you following it/on target?
(Required)
Yes
No
What do you feel is off target?
Who You Are/What You Do (products/services)
Describe what you do
(Required)
Describe what you do in 10 words or less
(Required)
What is different about the product or service that you offer?
(Required)
List the BENEFITS of the service you provide or products you sell. Focus on the BENEFITS, not the features: (i.e. Automobile Feature: Air Conditioning - Benefit: cool, comfortable ride)
(Required)
Add
Remove
Competition
List 3 competitors:(businesses who offer similar services in the same proximity and could possibly have the same customers as you)
Competitor #1:
(Required)
Competitor #2:
(Required)
Competitor #3:
What are your competitor’s biggest failings/short comings?
Competitor #1 (failings):
(Required)
Competitor #2 (failings):
(Required)
Competitor #3 (failings):
What do they do that you don't or wish you could?
(Required)
What assets, intellectual property, patents, licenses, certifications, etc that your competitors don't?
(Required)
Is there a process or a way of doing things that is different that your competitors?
(Required)
Have you tried putting a new spin on an old idea or do something different than the industry norm or done anything to stand out from your competition?
(Required)
What are the top 2-3 reasons prospects DON'T buy from you?
(Required)
Audience/Target Market
Who is your target market?
Who do you PRIMARILY service?
Businesses (B-to-B)
Consumers (B-to-C)
Business Professionals (B-to-P)
List top level business demographics
(Required)
List top level Consumer/Professional demographics
(Required)
How would you appeal to your target audience? (Why would they like you/your service)
(Required)
Is your target market ACTIVELY LOOKING for your services? How do they search?
(Required)
What do your customers really want… from their point of view? (Be specific. Don’t just answer a “quality product,” “low prices,” or “outstanding service.”)
(Required)
What are your target market's concerns, fears, issues, challenges?
(Required)
How do your products/services solve those wants for your customers or address their fears and concerns?
(Required)
Existing Customers
How many existing clients do you have?
(Required)
Have you ever asked a new client why they chose you? What was their answer?