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12
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1
Name
*
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First Name
Last Name
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2
Phone Number
*
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Area Code
Phone Number
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3
Email
*
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example@example.com
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4
Are you currently working with a real estate agent?
*
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YES
NO
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5
What services do you need?
*
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Buy property
Looking for rental property
Sell property
Apartment locating
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6
Where in Houston and surrounding areas are you looking in?
*
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7
If renting, when is your move-out date?
*
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8
If buying, have you been pre-approved by a lender?
YES
NO
Still shopping for a lender
YES
NO
Still shopping for a lender
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9
What's your budget?
*
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10
How many bedrooms?
*
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11
Do you have any pets?
*
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YES
NO
YES
NO
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12
Comments and questions
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