Purpose: Help business owners identify if they’re ready to grow, need a tune-up, or should consider restarting smart with support from Dr. Shanté of Bluestone Capital Group. *

First Name *

Last Name *

Email *

Phone *

Address

Street Address

City *

State *

Country

Postal code

Business Name *

write NONE if not applicable

🧠 Section 1: Smart Foundation Check (Chapters 1 & 2)

Do you have an Employer Identification Number (EIN)? *

Yes

No

I'm not sure

Have you officially registered your business with the state? *

Yes

No

Do you have foundational documents in place? (e.g., Articles of Incorporation, Operating Agreement, Bylaws) - please check all that apply *

Do you have a clear mission statement for your business? *

Yes

No

Have you ever stopped or restarted your business before? *

Yes

No

I’m doing that now

Would you like to receive personalized feedback from this diagnostic? (Required to collect email) *

Yes, send to my email

No thanks

💰 Section 2: Financial Fortification (Chapters 3 & 4)

Do you have a separate business bank account (not personal)? *

Yes

No

If you have a business bank account, approximately how much money is being deposited into your business bank account each month? *

Do you use a system to track income and expenses (e.g., QuickBooks, bookkeeper)? *

Yes

I do it manually

Not At This Time

If Yes or manually, please share your system to track income and expenses.

Do you file your annual report or compliance documents each year? *

Yes, I do it myself

Yes, I have a 3rd party file on behalf of my business

No

Do you have a working business budget or financial forecast? *

Yes

No

I started one but didn’t finish

📬 Section 3: Credibility & Professional Image (Chapters 5–8)

Do you use a business phone number (not your personal cell)? *

Yes

No

Do you have a professional business email address (e.g., [email protected])? *

Yes

No

What type of address do you use for your business? (Select one) *

Virtual address

Physical office or retail space

My home address

I don’t have a formal address yet

📈 Section 4: Visibility & Planning (Chapters 9 & 10)

Do you have a website or landing page for your business? *

Yes

No

Do you currently have a written business plan? *

Yes, it’s updated

Yes, but it's not updated

I started one but haven’t finished

I don’t have one

💳 Section 5: Credit to Capital Readiness (Chapter 11)

Is your personal credit score 650 or higher? *

Yes

No

I'm not sure

Is your business registered with D&B, Experian Biz, or Equifax Business? *

Yes

No

I'm not sure

Do you have business tradelines (credit cards, vendor accounts, etc.)? *

Yes

No

I'm not sure

Do you have a digital file or folder with all of your business documents ready? *

Yes

No

Do you own real estate property or would you like to own property? *

No/Not at this time

No, but I would like to buy a home

No, but I would like to buy an investment property

Yes, but I would like to buy more property

Let's Learn More About You...

What best describes your current situation? (Select one)

Do you have any specific challenges or goals you’d like to share?

How would you prefer to be contacted? (Select one)

Would you like to learn more about business coaching with Dr. Shanté through Blue Stone Capital Group?

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