Intake Interview v16 COPY-TOOLS

00:00Ready

1. Qualifier & Primary Caller

What are you calling about today?

🚗 Auto 🏠 Home 🔑 Renters ❤️ Life 🏢 Business

First Name

Last Name

Phone

Email

Date of Birth

Current Mailing Address

Lead Source

Urgency / Timeline Notes

2. Household & Drivers

MEMBER #1: PRIMARY CLIENT (Synced from Section 1)

First Name

Last Name

Date of Birth

Phone

Current Address

Email

3. Vehicles

4. Home / Property

Risk Address is same as Mailing Address?

Risk Street

City

Zip

Dwelling Type

Year Built

Est. Sq Ft

Roof Year

Flooring Type(s)

Countertops

Mortgage Amount

Property Notes / Additional Details

🔻 Additional Underwriting & Hazards

Swimming Pool?

Trampoline?

Wood Burning Stove?

Business on Premises?

Major Systems Updated (Wiring/Plumbing)?

5. Life & Health Notes

Life Conversation Notes