Client Self Assessment

Client Self Assessment Form

Contact Information

Name:     
Address: 
City:            State:    Zip:

Email Address:     Phone: 

Tell me about your business

Industry:      # of Employees
Current Administrative Support:  Yes  No
If no, why not?  Cost   Space  Not enough work  Other
Does your business experience seasonal fluctuations? Yes  No

What are some of your short term goals; i.e. establish web presence, implement newsletter, develop marketing campaign, increase client/customer base.


What non-core business activities are robbing your time each week?

Administrative Tasks               Hours
Email/Voice Mail                      Hours
Marketing                               Hours 
Data Analysis/Reporting         Hours 
Other          Hours 
Other          Hours 

If I had more time, I would
to grow my business.

If I had the skills, or time to learn the skills, I would implement
to grow or manage my business.

What is your vision of the ideal assistant: 

Software in use:
Microsoft Word                    Microsoft Outlook       
Microsoft Excel                    Microsoft Access         
Microsoft Publisher             Microsoft PowerPoint  
Microsoft FrontPage           QuickBooks:                
Corel Draw              

Others: