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Client intake form
A one-page new-client form that collects contact details, what the person needs, a budget and timeline, and how they found you. It is for service businesses such as landscapers, designers, cleaners and consultants taking on a new customer.
- Type your details or print blank
- Print or PDF, Letter or A4
- Free, no sign-up
On this page
What prints
The top of the page carries your business details, if you typed them, and the title Client Intake, with two lines to fill in: Date and Client no. The form then runs in three parts.
About you collects the client's Name, Company (if any), Phone, Email, Street address, and City, State and ZIP. A line under it asks for the best way to reach them, with boxes for Call, Text and Email, and a line for the best time.
What you need shows your services as tick boxes, three to a row, followed by a ruled box titled Describe the job or project, and three lines for Budget, Ideal start date and Deadline. A question underneath asks how they heard about you, with boxes for Friend or referral, Web search, Social media, Ad or flyer, Repeat client and Other.
At the bottom are an Anything else we should know box and a Client signature line.
The settings
- Your business. Name, address and phone, four lines and 200 characters at most, printed in the page header.
- What you offer (for the services list). Up to 160 characters, one service per line, up to six lines. Each line becomes a tick box. Leave it empty and the services section holds only the description box.
Getting the services list right
Use short, client-friendly names. "Lawn care", "Landscaping" and "Snow removal" read faster than "Seasonal turf management". Six boxes is plenty; if you offer more, group them. A client who is not sure what to tick can write it out in the description box, and that is often where the real job shows up.
Worked example: a home cleaning service
A cleaner types her name and number in the business box and these services: Regular cleaning, Deep clean, Move-out clean, Windows, Laundry, Organizing.
A new client, Priya Shah, fills it in at the kitchen table. She ticks Call, writes "after 5 pm" for best time, ticks Deep clean and Windows, and writes in the description: "3 bed, 2 bath, 1,400 sq ft, two dogs, first clean before in-laws visit." Budget: "$250 to $300." Ideal start: "Nov 20." Deadline: "Nov 24." She ticks Friend or referral, and the cleaner writes "Rosa from next door" in the margin.
Back home, the cleaner gives Priya a client number, writes it at the top, and uses the details to send an estimate. Later the signed form goes in the file with the invoice.
Handling personal details
A form like this holds names, addresses and phone numbers. The FTC's guidance for businesses says to collect personal information only when you have a real need for it and to shred paper records once that need ends. Ask for nothing beyond what the job requires, store completed forms somewhere that closes, and do not add fields for card numbers or Social Security numbers. Nothing you type into this page leaves your browser before you print.