Repeat Client Counseling Request Form
Client Name:
Address:
Business Name:
Phone:
Describe specific assistance requested
Have you hired any new employees since your last appointment?
Yes
No
If yes, how many?
Have you had to let go of any employees since your last appointment?
Yes
No
How many employees do you currently have including yourself?
Have you received any financing since your last appointment?
Yes
No
If yes, how much and from whom
(Please include, private investors, owner investment, SBA, Banks, etc.)
Have you received any government or commercial contracts since your last appointment?
Yes
No
If yes, what was the amount of contracts you were awarded?
Please share any other successes you have had since your last appointment: