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Client Intake Form
All fields must be completed in order to submit and initiate work.
Name
Company Name
Company Address
Company Phone Number
Company Email
What phone number will the leads need to be forwarded to?
What email will the leads need to be forwarded to?
How many phone calls do you want per month?
What offers or discounts do you currently offer your clients? If not applicable, please state "not applicable."
How is your product or service different than your competitors?
How is your product or service currently delivered? By a face-to-face appointment? A website? Office walk-in?
Is there an obvious problem your product or service solves? If yes, please explain.
Are there 3-4 steps your customers would take that would lead them to a sale? If yes, please list the steps.
How have you alleviated customer’s fears of doing business with you in the past?
What are the positive changes your customers will experience if they use your product or service?
Is there anything else that you think we should know that can help your business marketing efforts?
Submit