We appreciate your feedback. This questionnaire is 100% confidential. Feel free to fill out as much or as little information as you desire.

Name:
E-mail:
Phone:
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Business Name:
Number of Employees:
1. What frustrates you the most about your business?
2. What are you trying to accomplish this year?
3. What do you need to double your business this year?
4. What strategies have you tried in your business that worked, and didn’t work?
5. What would an outside party be able to do for you or a problem that they could help you solve that would significantly impact your business for the better?