Credit Consultation Scheduling Form

A form that lets clients book a credit consultation appointment and share their financial situation and goals ahead of time.

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Schedule Your Credit Consultation

Name

First Name

Last Name

Phone Number

Please Have Your Credit Report on Hand for Your Appointment, or Be Prepared to Have It Pulled

Date

Time

Tell Us About Your Situation

What Questions Do You Have About Our Service?

Improving my credit score Disputing errors on my report Understanding my credit report Debt management options Other

How Soon Are You Looking to Accomplish This?

Immediately Within 1 month 1–3 months 3–6 months No specific timeline

What Is Your Credit Goal?

Buy a home Buy a car Qualify for a loan Improve credit score Remove negative items Other

What Is Currently Affecting Your Credit Negatively?

Late payments Collections High credit card balances Bankruptcy Identity theft/fraud Other

Are You Currently in Bankruptcy?

Yes No

Are You Currently in Default or Delinquent on Student Loans?

Yes No

Are You Able to Pay Your Current Bills Comfortably Over 6–9 Months?

Yes No

How Did You Hear About Us?

Contact Authorization*

I agree to be contacted regarding my credit consultation appointment

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