Buyer Intake Form

Date:__________________ Source of Lead__________________________

Status: A B C (circle one)

Prospects Name: _____________________________ Spouse:______________________Kids?_______________

Address: ______________________________ City: ____________________ State: _______ Zip: ____________

Phone: _________________ Email: ______________________________ Text: YES/NO Preferred: _________

Own: _____ Rent: _____ Closes:__________ Lease Expires: ______________ Rent Amount: ______________

If they own, is house on the market? YES NO If yes, are they buying with agent? YES NO

Need to Sell first? YES NO How long looking for home?_____________

If YES, Get Listing!

Criteria Working with another Agent: YES NO

Motivation Level: 1 2 3 4 5 (1 low 5 high) Best time to look:  Day  Evening  Weekday 
Weekend
Price Range: ___________________ to ___________________ Time Frame: ___________________________
Desired Areas: _______________________________________________________________________________
# Bedrooms:___ # Bathrooms:____ Garage: _____ Pool: ______ Style of Home: _______________________
Any special needs? ____________________________________________________________________________
What are the most important things I can do for you as your Realtor?
___________________________________________________
Initial Consultation Date:____________________ Time:_______________ Follow-up on:_________________
NOTES:_____________________________________________________________________________________________________
______________________________________________________________________________________________________________

Follow Up Date Status Follow Up Date Status

And Time And Time
_____________ ______________________________________ ___________ _____________________________________

_____________ ______________________________________ ___________ _____________________________________

_____________ ______________________________________ ___________ _____________________________________

NOTES:_______________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

Mortgage Information
Mortgage Company: ______________________________________ LO:_________________________________
Phone:____________________________________ Approved Amount:__________________________________
Notes:______________________________________________________________________________________

GREAT, let me take a moment to make sure I have all the information I need!