Form-Business Assessment Questionnaire
Form-Business Assessment Questionnaire
This questionnaire is intended to help you assess the current status of your business. Every business owner will benefit from this exercise because it will allow him/her to identify strengths and weaknesses and, thereby, act as an aid in decision-making. If you feel uncomfortable sharing some of the information with Ad-Hoc Business Resources, LLC, leave those questions blank, but be sure to keep a completed copy, with totally honest answers, in your files. Update it regularly (review it at least every 6 months more often if market factors change significantly).
COMPANY NAME: _____________________________________________________________ ADDRESS: _____________________________________________________________ _____________________________________________________________ CITY: ___________________________________________ STATE: ____________ ZIP: ____________________ TELEPHONE: ( ) __________________ FAX: ( ) __________________ CELL: ( ) _______________
E-MAIL: _______________________________________
WEBSITE: ____________________________________
COMPANY STATISTICS: (Check all that apply) Business Start Date: ____________________ Has business operated continuously since then? [ ] Yes [ ] No [ ] Started from scratch [ ] Franchise [ ] Branch [ ] Purchase from another [ ] Spin-off of Larger Firm [ ] Inherited [ ] Other ______________________________ [ ] Other ________________
[ ] Home-based
[ ] Leased Facility
[ ] 12 Months/year
[ ] Manufacturing
[ ] Distributor
[ ] Consultant [ ] LLC
[ ] Partnership
[ ] LLP
Skilled: _______
Current Level of Your Product/Service Quality: Current Level of Your Customer Satisfaction: Current Level of Your Employee Turnover:
[ ] N/A
Are Your Sales Are Your Profits Are Your Receivables Are Your Payables Is Your Inventory Is Your Customer Count Is/are Your Market(s) Is Your Industry Is Your Competition Is Your # of Repeat Customers Are Your Customer Complaints
BAQ Form: Revision 0811-19
Steady ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______
Growing ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______
Declining ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______
Dont Know ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______
Cant Find Info ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______
All rights reserved
Your credit rating (score) is: [ ] Excellent [ ] Good [ ] Fair [ ] Poor Do you have a [ ] commercial or [ ] SBA loan for your business? [ Do you use credit cards to fund your business? [ Have you borrowed money from family and friends to run your business? [ Have you used equity investors to fund your business (Angel or VC) [ Do you currently qualify for business loans? [ Do you carry a line-of-credit for your business? [ Have you been turned down for a loan or line-of-credit? [ Do you have sufficient funds to operate your business? [ Are you running out of funds to operate your business? [
[ [ [ [ [ [ [ [ [
] No ] No ] No ] No ] No ] No ] No ] No ] No
Are you: [ ] Comfortable [ ] Confused [ ] Overwhelmed with the responsibility of running a business? Have you ever failed at, or closed, a business you owned? [ ] Yes [ ] No Have you ever sold a business you owned? [ ] Yes [ ] No Do you attend business courses, training, seminars, etc? [ ] Often [ ] Seldom [ ] Never Do you want to expand or diversify your business? [ ] Yes [ ] No Are you attempting to save your business from failure? [ ] Yes [ ] No Do you want to sell your business? [ ] Yes [ ] No If so, is it ready for sale? [ ] Yes [ ] No Business Skills Assessment: (Honestly evaluate your skills in the areas listed below with a checkmark) Skill / Knowledge Area Finance / Banking Procedures Accounting / Bookkeeping Cash Flow Management Credit and Collections Management Ability Inventory Control Business Planning Industry Knowledge / Experience Personal Organization Ability / Willingness to Obtain Assistance Market Analysis / Market Planning Analysis of Your Competition Advertising / Public Relations Pricing and Distribution Sales Procedures and Systems Customer Service Procedures Business Legal Issues Tax Compliance Licensing and Regulations
BAQ Form: Revision 0811-19
Strong [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ]
Adequate [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ]
Weak [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ]
Very Weak [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ]
[ ] [ ] [ ]
[ ] [ ] [ ]
[ ] [ ] [ ]
[ ] [ ] [ ]
All rights reserved
If applicable, List Your Strengths in: Engineering, Research and Development, Production, and/or Quality Control.
[ ] e-Commerce
[ ] Government Contracting
[ ] Military Contracting
[ ] AS-9100
[ ] Others: __________________________________________________
[ ] In Process __________________________________________