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CGemSpeaks Pre-Consultation Form
This form is used to collect information and material that will be used during the consulting & production process. By completing this form throughly, you help ensure that we can meet your needs.
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* Indicates required question
Email
*
Your email
Name
*
First and last name
Your answer
Contact number
*
ex: (012) 345-6789
Your answer
City & State
*
ex: Largo, MD
Your answer
Are you a:
*
Entrepreneur
Small business owner
Non-profit Organization
Other:
Do you currently work a "9 to 5"?
*
Yes
No
N/A
If so, are you planning to leave your "9 to 5" in the next:
*
3 months
6 months
1 year
I haven't considered when I plan to leave.
I haven't considered leaving at all.
I don't intend on ever leaving my "9 to 5".
N/A
If not, what is your main source of income:
*
My business
Various odd jobs
I don't have one
Other:
What type of consulting are you looking for:
*
Please select all that apply.
group sessions
one-on-one sessions
an online course or program
support from a online community
Other:
Required
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