Home . Client Intake Form

Client Intake Form

Thank you for reaching out to Peach & Pooch. This short intake helps us understand your practice, your goals, and how we can best support you. Not all questions are required.

Contact Information

Practice Name

Owner Name

Preferred Email

Phone Number

Best way to contact you (Email / Phone / Either)

Practice Snapshot

Practice Location (City, State)

Number of doctors (FT + PT)

Approximate number of support staff

Years in operation

Current Focus Areas

What’s Prompting You to Reach Out Right Now?

Briefly describe what’s feeling most challenging or unclear today.

Goals & Outcomes

What would “success” look like if we worked together over the next 6–12 months?

Financial & Performance Context

Approximate annual revenue range

Are financials currently reviewed regularly?

Timing & Engagement Style

How soon are you hoping for support?

What type of support are you most interested in?

How Did You Hear About Peach & Pooch?

What type of support are you most interested in?

Anything Else You’d Like Us to Know?

Next Step Acknowledgement

I understand this intake does not create a consulting relationship and is for initial review purposes only.