Client Intake Form
Welcome to a personalized client experience. Thank you for reaching out and expressing interest in learning more about buying or getting assistance with renting in Jacksonville, FL & surrounding areas. I’m excited to work with you and help you throughout the entire process.This intake form allows me to learn more about your needs so I can guide you with excellence, strategy, and care every step of the way. Once this form is completed, schedule your 15 min Buyer Discovery Call https://calendly.com/lorealluxuryestates-info/15min.Thank you, Lashanda L’oreal Wall| Realtor®️ | Florida Homes Realty & Mortgage| SL3528665 | Info@lorealluxuryestates.com
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Marital Status
*
Married
Not married
Divorced
Are you looking to buy or rent?
*
Buy
Rent
Are you a 1st time Buyer?
*
Yes
No
If Buying, have you been pre-approved for financing?
*
Yes
No
Need lender recommendation
How much are you pre-approved for?
*
If renting, What is your budget for rent monthly?
*
Preferred Location(s)
*
What area of town or zipcode if known are you interested in moving to?
*
Property Type
*
Please Select
Apartment
Single Family House
Two Story Home
Condo
Townhouse
Other
Number of Bedrooms
*
Please Select
Studio
1
2
3
4+
Number of Bathrooms
*
Please Select
1
2
3+
Budget Range (USD)
*
Desired Move-In Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Do you have retirement 401k or savings?
*
Yes
No
Are you an active duty military, retired or veteran?
*
Yes
No
What is your employment status?
*
Employed
Self employed
Retired
Unemployed
How long have you been Employed?
*
1-2 years
3-5 years
More than 6 years
6 months or less
Do you currently rent or own?
*
Rent
Own
Other
How soon are you looking to buy?
*
1-3 months
6 months - 1yr
when my lease is up
When is your lease up?
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Are you selling your current residence?
*
Yes
No
Other
Have you ever been evicted?
*
Yes
No
If so, please explain when and briefly what happened?
*
Do you have student loans?
*
Yes
No
If so are they in deferment or delinquent?
*
Deferment
Delinquent
Preferred method of contact?
*
Call
Both call and text
All of these above
How did you hear about me?
*
Referral
Facebook
Tiktok
Instagram
Past client
other
If referral, Who were you referred by?
*
Is there anything else you would like me to know, that will better help me assist you during your buying or renting process?
Submit
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