Blueprint Financial – Credit Intake

Blueprint Financial – Credit Assessment

Complete all sections to start your credit journey.
Section 1: Personal Information
Full Name

First NameLast Name
Date of Birth

MonthDayYear
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Who refered you ?
Name or Company you were refered by
Credit Status
What is your main goal right now?
Are you currently in an Active Bankruptcy ?
What is your estimated credit score?
Have you ever worked on your credit before?
Do you have any recent bankruptcies, foreclosures, or repossessions?
Credit Goals
What are you trying to get approved for?
When are you looking to get started?
Smart Credit Enrollment
Have you enrolled in Smart Credit using our link?
Do you understand that Smart Credit enrollment ($1 to start, then $39/month) is required to move forward?
This gives us access to your full credit report so we can monitor changes, track progress, and accurately work on improving your credit
Additional Details
What are your primary goals with your credit ?
What is your main concern with your current scores? What negative account do you have reporting on your report that is holding you back?
Service Agreement & No Refund Policy
By submitting this form and making payment, you agree to the following:
• Blueprint Financial provides credit document preparation services only. No specific results are guaranteed.
• All information provided must be accurate. Results vary based on your credit profile and participation.
• All payments are final and non-refundable. Services begin immediately upon payment.
• You agree not to file chargebacks or payment disputes. This agreement serves as proof of services rendered.
• You may cancel future services at any time, but no refunds will be issued for payments already made.
By proceeding, you acknowledge and agree to these terms.
Signature
Date

MonthDayYear
Date

Packages

Startup Plan

Document Prep Fee

$210 Quantity

Growth Plan

Document Prep Fee

$525 Quantity

Elite Funding Plan

Document Prep Fee

$945 Quantity

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Total

Payment Methods

Credit Card

Apple Pay

Google Pay

Afterpay

Should be Empty:

Blueprint Financial – Credit Assessment

Section 1: Personal Information

Credit Status

Credit Goals

Smart Credit Enrollment

Additional Details

Packages*

Payment Methods

Packages