Buyer Intake Form

Buyer Intake Form

Complete this form to help us best serve you.
Name (Buyer 1)*
Email*
example@example.com
Phone #*
Name (Buyer 2)
Email (Buyer 2)
example@example.com
Phone # (Buyer 2)
Current Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Have you spoken with any other real estate agents?*

YesNo
Have you signed anything with any other real estate agents?*

YesNo
How quickly do you want to buy?*

YesterdayReady Right NowNext 6 MonthsNext 12 MonthsDepends on job factorsOther
Have you been pre-approved with a lender*

YesNo
Lender Name (If you do not have one, enter "Need Referrals")*
Lender Company (If you have one.)
Lender's Phone Number (If you have one.)
Lender's Best Phone Number
Lender's Email (If you have one.)
example@example.com

Let's talk WANTS now!

What are your additional "WANT'S" in a home? What are some additional things you would like to make more of a perfect home, however you could live without it? Or it could be something you could improve yourself down the road? (Ex. You want hardwood floors however the home has carpet, so you could install hardwood floors later.)
List all your wants including more beds, baths, bonus, fireplace, etc....
If you have already seen homes you like, please enter the property addresses here.
Anything else you want to let us know before our appointment?
Lastly, what are 3 Things you expect from a REALTOR®?
I AGREE*

I confirm that I am freely supplying my contact information to LeighAnne DuChene. By providing my phone number and email address, I agree to receive text messages and emails from LeighAnne DuChene.
Should be Empty: