New Client Registration Form
Client Details:
Full Name
*
First Name
Last Name
Preferred pronouns
Second Client Name
First Name
Last Name
Preferred pronouns
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
What is your preferred method of communication?
Text
Phone Calls
Email
Have you already scheduled your initial consultation?
Yes
No
When is your consultation?
-
Month
-
Day
Year
Date
What are your preferred times / days?
How did you hear about us?
*
Please Select
Social media
Internet
Word of mouth
Other
Please Specify
*
Whom may we thank?
*
Tell us more about how we can help!
Feel free to share as much or as little as you'd like, but the more we know ahead of time, the more prepared we'll be for your consultation! We can also help with a wide variety of projects including: kitchen gardens, indoor growing, composting, backyard chickens, water conservation, water features, native planting, organic pest control, wildlife habitats, group projects for children / families / adults, and more!
What type of projects do you have in mind (i.e. specific plants you wish to grow, setting up for chickens, composting, etc)
Tell us about your space (i.e indoor growing, balcony, yard, community garden, etc):
Do you know approximately how much natural light your space recieves (i.e hours of sunlight per day, partial shade, full shade, etc)
How much time would you ideally spend on your garden?
As little as possible
2-5 hours weekly
6+ hours weekly
Other
How would you describe your previous gardening experience and how confident you feel?
Do you have any specific questions or issues you're dealing with?
Do you have an idea of your budget?
Up to $300; it doesn't need to look pretty, I'll grow in old buckets if I have to!
$300 - $600
$600 - $1,000
$1,000 +
Other
What amount of help do you hope to get from Raised Up Gardening?
Consultation only
Consultation and installation
Consultation, installation, and regular maintenance
I'm not sure yet
Other
Anything else you'd want us to know?
Please verify that you are human
*
Submit
Should be Empty: