Client Intake Form | The Hickory Algorithm Coaching

Section 1 of 5

About You

Start with the basics. This helps Chris know who he's sitting down with before the conversation begins.

First Name *

Last Name *

Email Address *

Phone Number How do you prefer to be reached between sessions?

Preferred contact method

Text Email Phone call Any works

Best time to reach you

How did you find The Hickory Algorithm?

If referred, who sent you? Optional — helps Chris connect the dots.

Section 2 of 5

Your Business

Tell us about what you do and where you stand. No judgment — just context.

Business Name *

What type of business is it?

Describe your business in 1–2 sentences. How would you explain it to someone you just met?

How long have you been in business?

How many people work in the business?

Who are your best customers? Describe the type of person or business you love working with most.

Website (if you have one)

Section 3 of 5

Where Things Are Hard

This is where the real work starts. The more honest you are here, the more useful your first session will be.

What is your single biggest business challenge right now?

What have you already tried to fix this? Other coaches, marketing agencies, networking groups, courses — what have you invested in before?

Why do you think those things didn't fully work?

Section 4 of 5

Where You Want to Go

Let's talk about what winning looks like for you — 90 days from now and beyond.

What would a successful 90 days look like for your business? Be specific. Revenue numbers, new clients, a problem solved — whatever matters most to you.

Where do you want your business to be in 1 year?

Why does this matter to you personally? What's really driving you — beyond the business numbers?

What does success feel like to you?

Freedom of time Financial security Legacy Community recognition Making an impact Building something bigger Work-life balance

What's the biggest thing standing between you and those goals?

Section 5 of 5

Working Together

The last few questions help Chris understand how to work with you most effectively.

How do you respond best to accountability?

Gentle check-ins Direct and honest Challenge me Show me the numbers

How would you describe your working style?

Planner / structured Intuitive / gut-driven Creative thinker Analytical Relationship-driven Ready to act

Have you worked with a local business coach before?

Yes No

If yes, what was that experience like? What worked, what didn't, and what do you wish had been different about working with someone local?

Anything else Chris should know about you — personally or professionally? This is a relationship as much as a coaching engagement. Share what feels relevant.

What do you hope to walk away from your first session with?

Let's get to know your business.