FENG SHUI CONSULTATION BUSINESS QUESTIONNAIRE

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1 FENG SHUI CONSULTATION BUSINESS QUESTIONNAIRE Please take a few moments to answer this questionnaire, which will provide important information that will assist in conducting this Feng Shui consultation. To ensure an accurate consultation, please include floor plans (either A3 or A4 sized), which have been drawn to scale, with each level of the building taking up approximately 3/4 of a page. Please label the floor plan to show where key occupants or departments are located and the functions of the spaces or rooms. If you require floor plans to be drawn up, we can refer a service provider to assist you. Please return the completed questionnaire together with the floor plans as soon as possible prior to the consultation to: Feng Shui Concepts, PO Box 941, Gladesville NSW 2111 Australia, or via to Business Name:. Contact Person: Business Address:... Phone: Mobile:. Address:... Website: What are your main reasons for requesting this Feng Shui consultation? 1 fengshuiconcepts.com.au

2 Have you used a Feng Shui consultant in the past: Yes If yes, were you satisfied with the Feng Shui consultation: Yes If not, please explain why:... Please tick the following words that you would use to describe the atmosphere within the business premises: Lively Welcoming Cluttered Disorganised Chaotic Uncomfortable Organised Stressful Hectic Dreary Fun Relaxed Other. Additional comments: Is the property: Owned Leased Date of building construction:. How long has the business occupied these premises?.... How long do you expect to occupy these premises? 2 fengshuiconcepts.com.au

3 If extensive renovations have taken place in these premises, when did they occur and what was involved? Do you plan to extensively renovate the business premises in the future? If so, when, and what do you expect will be involved? Briefly explain the history of the land or building. For example, was it an aboriginal sacred site, an industrial site, farmland etc Briefly describe the history of previous occupants of the land and building, and their reason for moving from these premises. (eg. business failure, expansion, legal problems etc): How many staff are there in this business: 3 fengshuiconcepts.com.au

4 Ho many offices are there on this site:.. Does the business use a warehouse: Yes If Yes, where is this located?... Please list the details for the key managers who work in these premises: Name Job Title Date of Birth Time of Birth Place of Birth Location in Floor plan Briefly describe any major changes that have occurred since moving to these premises (eg. financial status, debtors, theft, legal problems): 4 fengshuiconcepts.com.au

5 Do you have a business plan? Yes Do you have a marketing plan? Yes Briefly describe your business goals for the next 3 years: Have you or other staff noticed any significant changes to their health since occupying these business premises? Yes If yes, please expand: Has any strange phenomena occurred in these premises? Please explain: Do you have any issues or problems with the neighbours: Yes If yes, please expand Do your neighbours seem to constantly move premises? Yes Have you experienced theft or burglary in this building? Yes Please expand (when, how many times etc): 5 fengshuiconcepts.com.au

6 Have your neighbours experienced burglary here? Yes Do you require interior decorating and design advice? Yes Please expand: How did you hear about Jane Langof / Feng Shui Concepts? Association of Feng Shui Consultants Yellow Pages Australian College of Environmental Studies Google Recommendation (please provide details)... Other (please provide details).. DECLARATION This is to confirm that I, [contact name]. provide permission for Feng Shui Concepts to conduct a Feng Shui consultation for [business name].. and have the authority to do so. I understand that Feng Shui Concepts cannot provide any guarantees or take responsibility for the effectiveness or outcomes resulting from this consultation, as there are factors aside from Feng Shui which contribute to the state of the business. Signed:... Date:.. PAYMENT TERMS Please note that payment is required on the day of the consultation, via cash or cheque. Payment by EFT is accepted where cleared funds are received prior to the date of the consultation. Please contact us if you require EFT details. Thankyou. 6 fengshuiconcepts.com.au

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