1.Name

2.Email

3.Phone Number

4.Are you securities licensed?

Series 65, IAR under another RIA firm

Series 65, Own my own RIA firm

Series 6, 63, 7, etc. under a broker dealer

Insurance only

5.What are your goals for your business 3 years from now? 

6.How do your future goals compare with your present situation?

7.What do you feel has been your great challenge to reach your goals? 

8.What attempts have you already made to overcome those challenges?

9.What will the impact be to your family, livelihood, lifestyle and business if you don't reach your goals?

10.Do you have an assistant or staff?

Yes

No

11.What is the amount of total assets gathered in the last 12 months? 

12.Do you have  CRM/client portal? 

Yes

No

13.Do you have a system to track your ROI for each marketing campaign?

Yes

No

14.What types of prospecting do you current use? 

Seminars/Educational Events

Webinars/Virtual Presentations

Purchase leads online

Radio/TV ads

Social Media

Radio Show/Podcast

Referral programs

Other (please specify)

15.Where do you feel someone could make the biggest impact for your business?