Dallas TX Healthcare Home Buying Program

1

Have you worked in Healthcare for the past 12 months?* This field is required.

YESNO

2

What is your healthcare profession?This may include medical, dental, pharmacy, or nursing professions.

3

Do you currently Rent or Own?* This field is required.

Rent

Own

4

Which cities are you interested in?* This field is required.Please list 1-3 cities only

5

What is your estimated credit score?An estimate is fine!

620 or below

720 or above

620 - 700+

6

How soon are you looking to move?* This field is required.

Within a month

In 3-6 months

In 1-3 months

In more than 6 months

7

What is your monthly household income?An estimate is fine!

$1,000 to $3,000

$4,000 to $5,000

$3,000 to $4,000

$5,000+

8

What is the best time to reach you?* This field is required.

Morning

Afternoon

Evening

9

Are you currently working with a real estate agent?* This field is required.

YESNO

10

You're almost there! First name only please?* This field is required.Only 3 more questions to go!

11

Great {Name}! What is your email?Fake emails & phone numbers won't receive their healthcare home-buying benefits.

example@example.com

12

Last question {Name}! Verify current mobile number?* This field is required.Fake emails & phone numbers won't receive their healthcare home-buying benefits.