check

Client Discovery Questionnaire

You Can Do It Too! 

I struggled. Just like you, I truly wanted a change. To be my OWN boss, get off the insurance wheel and deliver my patients BETTER care.

Honestly, it was a struggle until I finally learned how to get my private practice started. These foundations are the most important thing you should consider before you start your Mobile or In-Clinic Nurse Practitioner Business.

As far back as I can remember I dreamed of becoming a nurse and helping people live healthy and better lives. 15 years ago I received my nursing degree and was ready to run! My desire for better patient care grew and I received my Nurse Practitioner degree 8 years later.

Working in traditional healthcare, I felt trapped. Large healthcare systems and massive insurance corporations were strangling proper patient care.

In 2021, I started my practice Well by AM Nursing, Inc. Today I am making over 200,000$ a year. I feel FREE! I make my own hours, I charge patients what I deserve to make, and best of all my patients receive exceptional care.

Let's Get Started! 

This form helps us understand your goals, challenges, and where you're at in your practitioner journey so we can support you effectively.

 

Start

Question 1 of 24

Full Name

Question 2 of 24

Email Address

Question 3 of 24

Phone Number

Question 4 of 24

What is the name of your business or startup (if applicable)?

Question 5 of 24

What type of practitioner are you?

(Select all that apply)
A

Nurse

B

Nurse Practitioner

C

Wellness Coach

D

Therapist

E

Health Educator

F

Other

Question 6 of 24

How long have you been practicing (in any capacity)?

A

Student or new graduate

B

1-5 Years

C

5-10 Years

D

10 + Years

Question 7 of 24

Which stage best describes your current journey?

A

I’m still in the idea phase

B

I have a plan or prototype

C

I’ve started offering services/products

D

I have paying clients

E

I’m ready to scale

Question 8 of 24

How clear do you feel about your target audience or niche?

A

Not clear at all

B

Extremely clear

Question 9 of 24

How are you currently connecting with or finding clients (if applicable)?

Question 10 of 24

Do you have a Digital Presence in Place?

Website, Instagram, facebook, Google page, etc. 

Question 11 of 24

What’s your top goal for the next 3–6 months in your nursing or wellness career/business?

Question 12 of 24

Are you building this solo or with support?

(Select all that apply)
A

Just me for now

B

I have a mentor or coach

C

Small team

D

Other

Question 13 of 24

What is your biggest challenge right now?

Question 14 of 24

What are your long term 3-5 year aspirations as a nurse entrepreneur? 

Question 15 of 24

 

What areas are you most interested in exploring with a coach?

(Select all that apply)
A

Career clarity or transitions

B

Starting/growing a business

C

Mindset & confidence

D

Time management & boundaries

E

Branding/marketing

Question 16 of 24

Would would success feel like and mean for you personally?

Question 17 of 24

What unique strengths or skills from your nursing background do you bring to entrepreneurship?

Think about how your clinical experience, communication, problem-solving, or empathy translate into your business journey.

 

 

Question 18 of 24

 

What does your ideal work-life balance look like?

Think about what balance means to you, and how it shows up (or doesn’t) in your current life.

 

Question 19 of 24

 

What are you hoping to gain from this coaching relationship?

Be as specific or open as you feel — clarity, structure, mindset support, strategy, etc.

 

Question 20 of 24

 

What qualities do you value in a coach?

(Select all that apply)
A

Supportive

B

Honest

C

Strategic

D

Empathetic

E

Direct

F

Experienced

Question 21 of 24

 

How do you prefer to receive feedback and accountability?

Examples, 

Gentle encouragement, direct honesty, check-ins, structured plans — what helps you grow?

Question 22 of 24

How soon are you hoping to take action or get support?

A

ASAP

B

Within the next month

C

1–3 months

D

Just exploring for now

Question 23 of 24

Do you have a budget or funding to invest in coaching, tools, or support?

A

Yes, I have a budget

B

I’m planning to invest soon

C

Not at this time

Question 24 of 24

Anything else you’d like me to know about your journey or goals?

Confirm and Submit