Client Intake Form
This form will gather pertinent information needed for your consultation and for service delivery.  The next step is to schedule your 30 minute consultation here Your consultation should be scheduled 72 hours from the date you complete your Client Intake Form.  

If you have questions, please contact us at Contact us at (615) 601-0833 or
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Email *
Are you a new or existing customer? *
Your name *
Business Name *
What is your website address? *
Best Phone number to reach you: *
Please enter your area code and phone number
Preferred contact method *
Define your industry. *
Define your key market (clientele). *
Tell me about your business? (What do you do, who do you serve, who is your ideal customer, what are your signature products, etc) *
What is your business vision? *
What is your business mission or mantra? *
What is your Annual Revenue Goal? *
What was your past years Sales? *
Where would you like to see your business in 90 days? *
What Products or Services are you currently selling or would like to sell? *
What are your biggest challenges with your offerings (clients, packaging, pricing, quality, leads, marketing, sales, etc)? *
What support do you feel you need for your business? *
Do you believe in self-investment to reach your life and business goals? Please explain. *
How do you handle feedback? How do you like to receive feedback? *
Why do you want to work with The RL Fleming Group? *
How did you learn about the 30-minute consultation? (be specific) *
Questions and comments
A copy of your responses will be emailed to the address you provided.
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