Thank you for your commitment to the Business Owners in our programs!

This form will do the following:

  • Create a consistent format for documenting outcomes of one-on-one meetings with business owners
  • Provide tracking for invoicing purposes for me and you and our client
  • Create accountability for the business owners to work on your recommendations
  • Provide one data entry point for reporting for all stakeholders

Please do this immediately after your meeting so WHC gets a copy, you get a copy, and the business owner gets a copy. This timely documentation is required by our contracts.

Also, to ensure that we are fairly administering government resources, please limit all your meetings to 15 minutes as contracted and limit your meetings with each business owner to two (2). We must be fair and consistent, and we must stay in budget. This data can and probably will be audited by county, state or federal agencies, so please be accurate! I can’t pay you without this documentation for each session.

After you hit Submit, wait for the success message to ensure it went through. You should receive a confirmation email. If you didn’t receive a confirmation email, please resubmit.

If you had a no call/ no show, do not fill out this form. Email Kim Anthony at and she will contact the business owner to reschedule.

Thank you! I appreciate you!