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SCHEDULE A CONSULTATION

CONTACT INFORMATION

First name

Last name

Company name

Email

Phone

Website (if applicable)

Preferred Method of Contact

SERVICE NEEDS

Type of Support Needed

Non-Financial Audit

Compliance Review

Policy Development

Internal Controls Assessment

Management Advisory

Other

Brief Description of Your Current Challenge or Need

ORGANIZATIONAL DETAILS

Industry:

Number of Employees:

Locations of Operation:

Existing Compliance Frameworks (if any):

AUDIT & COMPLIANCE INFORMATION

Have you undergone an audit in the past 24 months?

Yes

No

If yes, what type of audit and what were the findings?

Current Policies or Procedures in Place:

Known Gaps or Areas of Concern:

INTERNAL CONTROLS

Do you have documented internal controls?

Yes

No

Key Processes You Want Reviewed:

Any recent incidents or control failures:

ADVISORY & MANAGEMENT NEEDS

Areas where you seek guidance:

Strategic Planning

Organizational Structure

Risk Management

Staff Training & Development

Other

TIMELINE & BUDGET

Desired Start Date:

Urgency Level:

Low

Medium

High

Estimated Budget Range:

ADDITIONAL INFORMATION

Anything else you would like us to know:

Authorization By submitting this form, you acknowledge that the information provided is accurate to the best of your knowledge.

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CONTACT US

214-302-8177

keith@maddoxadvisoryassurance.com

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