Contact Form | Manual Entry

New Lead / Contact

Please enter in as much detail as possible. Enter the information below when you field a call from a prospective client. This form is for internal use only.
Contact Information
Name:*

First NameLast Name
Phone Number:*
Email*
Client Information
Selling or buying?*

Selling OnlyBuying OnlyBuy & Sell
Timeframe?

ASAPWithin 1 MonthWithin 2 MonthsWithin 3-6 Months6+ MonthsAfter purchasing another home
Property Information
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Client Intake Notes
Please enter as much detail about the client as possible.
Appointment Date & Time

Please ask the seller for some dates and times for an appointment. The agent will call the seller to confirm the appointment time.
Type of appointment?*
What is your preferred date/time to meet with an agent?*
Lead Source
Lead Source

Online / InternetMail AdvertisementReferral (Agent/Lender)Referral (Client/Friend/Family)Past ClientOpen HouseBillboardDoor AdvertisementFSBO ConversionGrocery Store AdNeighborhood Yard SignRadio / Television
Online Source

BingCleverFacebookGoogleHomelightYelpYoutube AdZillow
Referred by?
Who was the client referred by so we can credit them for sending us a referral?
Should be Empty:

New Lead / Contact