Credit Audit & Repair Service Form

Credit Audit & Repair Service Form
Credit Monitoring Required for Your Free Audit

To complete your credit audit, we require access to your current credit reports and scores. We use Credit Hero Score, a secure and reliable credit monitoring service, to pull your reports directly and keep your data safe.

If you are already signed up with Credit Hero Score, you’re all set—just complete the form below.

If you are NOT yet signed up, please register before submitting this form. Use the link below to create your account:

👉 Sign Up for Credit Hero Score Here

Note: Maintaining an active Credit Hero Score account is required throughout the audit and credit repair process.
YesNo
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Of Birth*

MonthDayYear
We use your DOB for identity verification to ensure we can accurately complete your credit audit.
Last 4 Digits of Your Social Security Number*
We use the last 4 digits of your SSN strictly for identity verification and to complete your credit audit. Your information is secure and encrypted.
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Client Signature *

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Date*

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Date
Credit Audit Consent
I authorize Consult With Cohen LLC to review my personal credit reports and related financial information for the purpose of conducting a complimentary credit audit. I understand that this audit is for educational purposes only and does not constitute enrollment in credit repair services. I also understand that no guarantees are made regarding outcomes, and that I will not be charged for this audit. I consent to being contacted by phone, email, or text regarding the results of my audit and any related services.
Consent Signature *

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Date of Consent *

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Date
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Credit Audit & Repair Service Form

Credit Audit Consent