Intake Questions for a Midterm Rental Guest (30+ days)
What property are you interested in?
Please select:
60XX S. Wabash St.
73XX S. South Shore Dr.
72XX S. Cornell
88XX S. Emerald
60XX S. Rhodes
16XXX Wood St.
What is your desired move-in date (and how flexible are you)?
-
Month
-
Day
Year
Date
What is your desired move-out date?
-
Month
-
Day
Year
Date
Tenant Information
Name of Applicant
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Number of other Occupants
Occupant Details
*
Why are you needing housing?
Traveling Nurse
Corporate Assignment
Relocation
Insurance Displacement
If insurance displacement, have you been assigned a housing adjuster?
Yes
No
What’s your monthly budget range (including utilities, parking, pet fees, and any required deposits)?
$1,000-$2,000
$2,000-$4,000
$4,000-$6,000
$6,000-$8,000
$8,000-more
Do you have any pets?
Yes
No
If yes, please specify the pet/s type and breed | House trained or crated
Do you smoke or vape (including cannabis)?
Yes
No
Do you have any special odor sensitivities or restrictions?
Yes
No
Do you need parking?
Please Select
Yes
No
How many vehicles? Size - (Compact/SUV/Truck)
Do you have any storage needs?
What are your must-haves for the space (furnished level, workspace/desk, in-unit laundry, AC, fast Wi-Fi, quiet hours, elevator, accessibility needs)?
Are you willing to complete the screening process? (ID verification, credit/background check if applicable)
Yes
No
Insurance Information
Insurance Company
Policy Number
Insurance Agent
First Name
Last Name
Insurance Agent Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Insurance Agent Email
Housing Representative
First Name
Last Name
Housing Representative Email
Housing Representative Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Claim Number
Please list 2-3 References with a phone number.
Submit
Should be Empty: