Client Intake Form - ScopeX Media

Profile

Business Information

Tell us who you are and how to reach you.

Goals

What are you trying to achieve and what do you need help with?

Plan

Be direct — knowing your real budget means no surprises on either side.

Referral Name (if someone referred you — we want to thank them)

Assets

Share what you have — handles, links, or URLs. Leave blank if it doesn’t exist yet.

Don’t share passwords here. Just confirm what exists. ScopeX will arrange secure access during onboarding.

Notes

Anything we haven’t covered — vision, concerns, or context for your first call.

What does your business look like in 3 years if everything goes right?

I confirm the information above is accurate and I am authorized to engage ScopeX Media on behalf of this business.

I agree to be contacted by ScopeX Media at the phone number and email provided above.

Gery personally reviews every intake and will reach out within 1 business day to confirm next steps and book your strategy call.