Client Registration
Welcome to Book-Smart
Name
*
First Name
Last Name
How many workable leads do you have for our team to call?
*
Please Select
Less than 100 (Ineligible for Service)
100-150
150-200
200+
Bronze/Silver requires 100 to 200. Gold requires 200+
Service Level
*
Please Select
BRONZE - 4 to 5 presentations
SILVER - 8 to 10 presentations
GOLD - 16 to 20 presentations
Lead Type
*
Please Select
Response Cards
Policy Owners
Best Phone Number for clients to reach you
*
-
Area Code
Phone Number
Email
*
example@example.com
Field Days
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Any schedule exceptions
*
Ex. Personal Appointments etc.
Start Date & Time
*
-
Month
-
Day
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
First Appt Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Last Appt Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Comments
What US states will you need us to call for?
*
ALL
NONE
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
What CAN provinces will you need us to call for?
*
ALL
NONE
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
What is your local timezone?
*
Calendly is required, Please provide your Link
*
Zoom credentials to share with your clients
*
ID Badge
*
Browse Files
Cancel
of
How would you prefer we handle call backs for missed appointments/no shows?
*
Please Select
Call them within 24 hours to re-schedule
Allow you to call them yourself
Submit
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