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Pre-Program Questionnaire

Before completing this questionnaire, it is a good idea to arrange a conference call to see if there is a good fit among Dr. Thea’s style, content, and your program needs. Please e-mail or call 803.767.4365.

This pre-program questionnaire will enable Dr. Thea to tailor her presentation to the specific needs of your group. Please feel free to skip over any questions you feel are duplicative or irrelevant due to the nature of your program.

Dr. Thea wants to learn as much as possible about your group and your event. It is not possible to give her too much information. Please share with Thea any printed information you feel would help her learn about your organization’s people and industry.  Examples include: meeting specific agenda (required), annual report, newsletters, promotional materials, current articles about your industry, and trade publications.

You may copy and paste this questionnaire into your word processing program, or you can select from the following two formats: Pre-Program Questionnaire in Adobe Acrobat pdf format or  Microsoft doc format. Please send it to: thea@drthea.com, fax to 888.838.4323, or mail to dr. thea, llc., 7001 St. Andrews Road, #134, Columbia, SC  29212.

Client Information

Your Name:

Business Phone:                         Cell Phone:                                            Fax:

Title:

Organization:                                         Website:

Best time for Dr. Thea or her assistant to reach you:

The Meeting:

  1. What is the meeting theme?
  2. What is the specific purpose of this meeting?
  3. What are the top 3 objectives for Dr. Thea’s presentation:

1)

2)

3)

  1. What are some sensitive issues to avoid?

The Presentation:

  1. What is Dr. Thea’s role in your program? (opening or closing keynote, breakout session, train-the-trainer, retreat leader, etc.)
  2. What is the name, title, and contact information of Dr. Thea’s introducer?

Name:                                      Title:                                         Contact Information:

  1. What are the exact times for Dr. Thea’s presentation?

Start Time:                                End Time?

  1. What is the best time for Dr. Thea to conduct her a/v and room check?
  2. How should Dr. Thea dress for the presentation?
  3. What is most important to you concerning the content of Dr. Thea’s program? (i.e. use of examples, group exercises, handouts, etc.)
  4. Are there any other speakers on the program? If so, please identify them by name, title, and topics they will discuss:
  5. Are there any messages you would like Dr. Thea to reinforce?

The Audience:

  1. Number in the audience?            Are spouses invited?
  2. Age range?                                Female %?                                Male %?
  3. Please list the names and contact information for 5 key people in your group who will be at the program. Dr. Thea will want to contact them to discover more information about your group.

Name:                                      E-mail:                                      Phone:

Name:                                      E-mail:                                      Phone:

Name:                                      E-mail:                                      Phone:

Name:                                      E-mail:                                      Phone:

Name:                                      E-mail:                                      Phone:

  1. General description of the audience:
  2. What other information should Dr. Thea know about the audience:

The Organization:

  1. What is your organization most proud of?
  2. What are some of the challenges your organization and people face on a regular basis?
  3. Do you have key phrases you often use?
  4. What are your biggest current and future opportunities?
  5. Who are your past and current organizational “heroes” (leaders admired, studied, or referenced)?
  6. What is unique about your group?
  7. Using only 3 adjectives, please describe the kind of presenter who has been a big hit with this group:

Adjective 1:                               Adjective 2:                               Adjective 3:

  1. How will you know if Dr. Thea was a hit?
  2. How did you hear about Dr. Thea?

The Logistics:

  1. Meeting location, address, phone, & fax:
  2. Name of meeting room:
  3. Dr. Thea’s hotel location, address, phone, & fax:
  4. Closest airport:
  5. Distance from airport in miles:                                                    and minutes:
  6. How should Dr. Thea travel to the hotel? (take cab, rent car, schedule driver, etc.)
  7. Would you like Dr. Thea to notify someone after she arrives at the hotel. Whom should she notify – name and cell?
  8. Contact at meeting site:

Name:                                      Title:                             Cell:                              On-site arrival date:

  1. Are there any pre-meeting engagements (i.e. reception, breakfast)? If so, where and when are they scheduled?

The Website:

Please feel free to create links from your website to Dr. Thea’s if you’d like to introduce your group to her prior to her presentation:  http://drthea.com

You may copy and paste this questionnaire into your word processing program, or you can select from the following two formats: Pre-Program Questionnaire in Adobe Acrobat pdf format or  Microsoft doc format. Please send it to: thea@drthea.com, fax to 888.838.4323, or mail to dr. thea, llc., 7001 St. Andrews Road, #134, Columbia, SC  29212.