Sample Client Call / Intake Form

Good morning / afternoon / evening, thank you for calling COMPANY NAME.	Date
MM	DD	YY
This is
Name of Representative/Executive
I’ll be glad to assist you today. May I please ask with whom I am speaking?	Name of Client
Thank you; client name, do you mind sharing your occupation?	Occupation
Have you used any of our services before?	Yes	No	Specify
How may I assist you today?	Client Requirement
Thank you! I will get back to you with more information within the next 2 hours/days/weeks
When would be a good time to reach you?	Time
What number should I call?	Phone Number
Is this your home, work or mobile number	Home	Mobile	Work
In case you miss our call (or give another reason), can I also please have your email address to share this information to you through email?	Email
IF LOCATION IS REQUIRED: Can you please share your address with me?	Address	City
State	Postcode
Is there any other information you want to share with us, (dietary preferences, person with disabilities, military, senior citizen etc.)?	Military	Vegan	Person with disabilities
Senior Citizen	Your Own	Your Own
Is there anything else that I can assist you with?	If Yes, add Client Requirement
Thank you for your interest in our services.
Once again, this is	from COMPANY NAME.
Name of Representative/Executive
You can reach us at PHONE NUMBER. We are available from	to	Mondays to Saturdays
all 7 days of the week.
I will be in touch with you soon. Thanks again for your call and have a wonderful day