Comprehensive Credit Repair Client Intake Form

Comprehensive Credit Repair Client Intake Form

Please complete this form thoroughly after your initial consultation to help us begin your credit repair process effectively.
Before we can begin working on your credit, you must be enrolled in a credit monitoring service that provides access to all three credit bureaus (Experian, Equifax, and TransUnion). This allows us to review your full credit profile, track your progress, and dispute any inaccurate or negative items on your behalf. When prompted in the monitoring portal after signing up, you MUST give Flourish Financial LLC permission to access your credit information.

All clients must sign up with MyScoreIQ, our trusted credit monitoring partner, as it provides the detailed reports and real-time updates necessary to effectively repair your credit.

It costs anywhere between $30-$40 a month and you can cancel anytime.
Here’s how it works:

• You’ll need to sign up for MyScoreIQ (required), a credit monitoring service that provides access to all 3 bureaus. Links can be found below.

This is your first step toward better credit, better opportunities, and a better future!
I understand that credit monitoring is required for credit repair services immediately, and I agree to sign up for credit monitoring before my onboarding is complete.I understand that if I fail to sign up, my application is no longer valid. I also understand and agree that I must retain an active monitoring account during my credit repair contract term to receive services.
Credit Login Signup Form

The following signups are a requirement to onboard successfully for credit repair. Please take some time to sign up for each service. Please use the following links to create your account:
CFPB LINK: USE THIS EXACT LINK

https://portal.consumerfinance.gov/consumer/s/login/SelfRegister
CREDIT MONITORING: MYSCOREIQ

https://www.myscoreiq.com/get-fico-max.aspx?offercode=432141WF
Client Full Name
Social Security Number:
Primary Phone Number
Email
example@example.com
Date of Birth

MonthDayYear
Current Address (Street, City, State, Zip Code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Address If At Current Address Less Than 6 Months (Street, City, State, Zip Code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Marital Status
Current Monthly Income (approximate gross income)
Source of Income
Are you currently behind on any bills or loans?
Do you currently have any open credit cards?
What services are you most interested in?
What are your primary goals for credit repair? (Select all that apply)
If you selected 'Other' for your primary goals, please specify:
Do you currently have copies of your 3-Bureau Credit Reports (Experian, Equifax, TransUnion)?
What is your current estimated credit score?
Please rate your understanding of your current credit situation.

1

2

3

4

5

6

7

8

9

10

1 is Very Poor Understanding, 10 is Excellent Understanding
On a scale of 1 to 5, how motivated are you to actively participate in the credit repair process?
Have you ever filed for bankruptcy?
Please indicate your preference for communication:
License or Identification:

Cancelof
Social Security Card:

Cancelof
Current Utility Bill:

Cancelof
I understand and agree that in order to receive credit repair services I must submit a picture of my license or photo ID, my social security card, and a current bill for proof of address.
Signature
Should be Empty:

Comprehensive Credit Repair Client Intake Form

Credit Login Signup Form

CFPB LINK: USE THIS EXACT LINK

CREDIT MONITORING: MYSCOREIQ