Coach Candice: New Client Survey
Hello and Thank you for choosing Coach Candice.

C.A. Ellis & Associates, LLC is a conglomerate of services delegated to aid individuals and small businesses to be the best version of themselves by “piecing together the pinnacle of success.” C.A. Ellis & Associates, LLC. is a sole proprietorship limited liability corporation owned and operated by Candice Ellis located in Eagan, Minnesota. C.A. Ellis & Associates, LLC is a certified WBEC/DBE/TG small women minority-owned consulting firm. Candice recently celebrated 6 years as an entrepreneur and has a combined 40+ years of 245D/Assisted Living service experience between her and her team.

The mission of C.A. Ellis & Associates, LLC. dba as Coach Candice is to provide fast and reliable services in auditing, consulting, coaching, and staff development to providers.

C.A Ellis & Associates, LLC. provides combined designated coordinator & manager contracted consulting services to providers in need of routine oversight, evaluation & support of program paperwork ensuring quality and program improvement, initial & ongoing preparation and review of paperwork for clients, and ensuring that your organization is compliant with policies & procedures as it pertains to the clients’ needs and staff training. With Coach Candice's team on board, you simply have to bring the clients and we take it from there  - from coordinating the intake meeting to ensuring moving forward all client paperwork meets compliance!! In addition, we also provide an array of ongoing tools that are beneficial to your overall business needs.

I ask that you complete of the new prospective client survey.

I look forward to speaking with you.

Until Soon,
Candice Ellis, MBA, MHPrac
Direct: 612.424.2495
Fax: 612.465.2576
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What is the name of the organization/company? *
What is the business mailing address? *
What Count(ies) Providing and/or Planning on Providing Services? *
Providers outside of the immediate metro area (Dakota/Ramsey/Hennepin County) will incur an additional transportation fee beginning at $50 on their monthly invoice.
What is your business website?
Primary Point of Contact, POC: *
What is the primary Point of Contact, role in business? *
Required
Primary Contact Number? *
Is there another number that you may be reached?
What is POC email address? *
Best way to contact? *
Required
Email Invoices should be sent to:
Name of Secondary contact, if applicable:
Name of Secondary Email address, if applicable:
What is the role of the secondary contact, if applicable
Who will serve as the Designated Coordinator (DC), If applicable?
Please note, this does not however affect the contract rate; as we will still need to ensure the paperwork is completed and provide oversight.
What is the DC's email address?
Who acts as the Authorized Agent? *
What is the Authorized Agency email address, if different from POC email
Type of Services seeking to obtain from Coach Candice: *
All services are flat fees based on type of services, number of indivudals served and staff employed - prices are non-negotiable.
Required
Type of Services Currently or Planning on Offering as a Provider? *
Required
Are you a current licensed DHS/MDH Provider? *
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