Client Intake Form

Thanks for your interest in Elrington Experience!

This form helps me get a clear picture of your business, your goals, and where your customer experience may need support. Whether you’re here for a quick audit, a full retention system, or custom CX help—I’m excited to learn more and see how I can support you.

Full Name*

First NameLast Name

Business Name*

Business Website (If applicable)

Phone Number*

E-mail*

example@example.com

What does your business do?*

Number of employees:*

Who is your target customer/client?

What are your top 1 to 3 business goals this quarter?

What prompted you to reach out about CX support?

What part of your customer experience feels unclear, broken, or inconsistent?

Are there any recent wins or pain points you'd like to share?

What would success look like at the end of our time together?

What services are you interested in?*

What is your approximate budget range?*

What's your ideal start date and timeline?*

Is there anything else you'd like me to know?

“I understand this form does not guarantee service, but helps us determine fit.”*

Check this box to continue.

Once submitted, I’ll review and follow up within 2 business days with a Calendly link for your 30-Minute Client Clarity Call.