Please answer all the questions below (see red alerts).

Sales

1. How satisfied are you with your selling skills?

   not 1 2 3 4 5 6 very

2. How satisfied are you with your ability to open new cases?

   not 1 2 3 4 5 6 very

3. How often do you complete printed fact-finders or confidential information questionnaires?

   not 1 2 3 4 5 6 very

4. How satisfied are you with your presentation packages?

   not 1 2 3 4 5 6 very

5. How satisfied are you with your sales closing ratio?

   not 1 2 3 4 5 6 very

6. How satisfied are you in providing referred leads to members of your target market?

   not 1 2 3 4 5 6 very

7. Do you receive a continuous flow of referrals to your natural target market?

   Yes No

Record Keeping

1. Are you satisfied with your sales record-keeping?

   Yes No

2. Do you complete a monthly P&L statement?

   Yes No

3. Do you complete a semiannual or annual balance sheet?

   Yes No

4. Do you use a Client Relationship Management (CRM) system?

   Yes No

5. Do you have and use a written business plan?

   Yes No

Financial Well-being

1. Is your personal life and disability insurance program up to date?

   Yes No

2. Is your casualty insurance program up to date?

   Yes No

3. Is your retirement plan adequately funded?

   Yes No

4. Do you have an adequate cash reserve fund?

   Yes No

5. Do you have and use a business budget?

   Yes No

Written Office Procedures

1. Do you have a written office procedures manual for all staff positions?

   Yes No

2. Is your compliance manual up to date?

   Yes No

3. Do you have written hiring and training practices?

   Yes No

4. Do you train your staff on a regular basis?

   Yes No

Business Priorities

1. Can you define what is most important in your practice?

   Yes No

2. How consistently do you do what is most important first?

   not 1 2 3 4 5 6 very

3. How satisfied are you with your business priorities?

   not 1 2 3 4 5 6 very

4. Would you like help in defining your business priorities?

   Yes No

Personal Health

1. How would you evaluate your current level of wellness?

   not 1 2 3 4 5 6 very

2. How well do you sleep?

   not 1 2 3 4 5 6 very

3. How is the quality and consistency of your exercise program?

   not 1 2 3 4 5 6 very

4. Do you have enough play and vacation time?

   Yes No