Contact Information
Full Name
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First Name
Last Name
Phone Number
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Is this a:
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Cell Phone
Work Phone
Home Phone
E-mail
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Are you currently married?
Yes
No
Spouse's Full Name
First Name
Last Name
Spouse's Phone Number
Is this a:
Cell Phone
Work Phone
Home Phone
Spouse's E-mail
General Questions
What services are you inquiring about?
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Financial Planning
Wealth Management
Tax Services
Other
Are you inquiring about services for your business?
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Yes
No
Maybe
What is the name of your business?
What is the nature of your business?
Have you previously worked with a Tax Preparer and/or Financial Advisor?
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Yes
No
Why are you looking to change your Tax Preparer and / or Financial advisor?
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What prompted you to start looking for a Tax and/or Financial Advisor?
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Please list the ideal days and times for your meeting with us.
How did you hear about us?
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