Intake — Amber Harrison - Realtor

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Amber Harrison

Epique Realty · Des Moines Metro

Client Survey & Intake Form

Tell us more about your real estate goals so Amber can guide your next step with clarity and care.

1. Buyer Information

First Name *

Last Name *

Email Address *

Phone Number *

Mailing Address

2. Co-Buyer Information

Co-Buyer First Name

Co-Buyer Last Name

Co-Buyer Email

Co-Buyer Phone

3. Pre-Approval & Lender

Are you pre-approved?

Pre-Approval Amount

Lender Name

Lender Phone

Lender Email

Lender Company / NMLS

4. Buyer Preferences

Price Range

Bedrooms

Bathrooms

Construction Type

Garage Stalls

Timeline

Square Footage

Lot Size

HOA Preference

Pool Preference

Yes No No Preference

5. Preferred Areas

Ankeny Urbandale West Des Moines Johnston Des Moines Altoona Waukee Open to Suggestions

Other Area / ZIP Code

6. Must-Haves

Garage Finished Basement Main-Floor Primary Large Yard Home Office New Construction Acreage Pool

7. Referral & Notes

How did you hear about Amber?

Referred By

Children / Family Notes

Additional Notes for Amber

Your information will be kept confidential and used only so Amber Harrison Realtor can follow up about your real estate goals.

License ID: S67173000
Company: Epique Realty, Inc

Call or Text (515) 473-8035 | amber@amberharrisonrealtor.com

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