Customer Intake Form (Service Business)
A simple new-customer intake form for a service business — contact details, the service requested, how they heard about you, contact consent, and signature.
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NEW CUSTOMER INTAKE FORM Bright Spaces Cleaning Co. Date: May 23, 2026 CONTACT INFORMATION Name: Sample Customer Phone: (555) 123-4567 Email: customer@example.com Service address: 12 Sample Street, Anytown, ST 00000 Preferred contact: Email Best time: Weekday evenings after 5 PM SERVICE REQUESTED Recurring home cleaning, every two weeks. 3-bedroom house, 2 baths. Have a friendly dog. Interested in first-visit deep clean. Budget / timeline: Looking to start within 2 weeks; flexible on day. HOW DID YOU HEAR ABOUT US? Referral - Referred by Pat Q. ANYTHING ELSE WE SHOULD KNOW? Please use fragrance-free products if possible. CONSENT TO CONTACT By signing, I agree that Bright Spaces Cleaning Co. may contact me about my request using the details above (calls, texts, or email). I can opt out at any time. SIGNATURE _____________________________ Date: ____________________ Sample Customer For office use only: Received by ____________ Follow-up by ____________ Lead # ________
About this template
A customer intake form is the first structured touchpoint between a service business and a new client, and a good one does three jobs at once: it captures the contact and job details you need to actually quote and schedule the work, it records how the customer found you (so you know which marketing is paying off), and it creates a tidy paper trail with a date and signature. Keep it short — every extra field lowers completion, and for an intake form the goal is to get enough to follow up, not to collect everything up front. The fields that matter most are the **contact method and best time** (so your follow-up actually reaches them), a **clear description of the service requested** in the customer's own words, and the **"how did you hear about us?"** question, which is the cheapest market research a small business can do — track it over a few months and you will see exactly where to spend your time and ad budget. Add a brief **consent-to-contact line** so you have permission to call, text, or email about the request; if you later send marketing messages, separate marketing consent and follow applicable rules (TCPA for calls/texts, CAN-SPAM for email). A small "for office use only" footer (received by, follow-up by, lead number) turns the form into a lightweight lead tracker. Use it at first contact — on a clipboard at the door, a tablet in the shop, or emailed as a fillable PDF — and store completed forms securely, since they contain personal contact details.
When to use it
- Onboarding a new client at a service business (cleaning, salon, trades, tutoring, etc.).
- Capturing leads from walk-ins, calls, or your website in one consistent format.
- Tracking which marketing channels bring in customers.
- Creating a signed, dated record of a service request.
What to include
- Customer name and contact details (phone, email, address).
- Preferred contact method and best time to reach them.
- A clear description of the service requested, plus budget/timeline.
- A "how did you hear about us?" question for marketing insight.
- A contact-consent line, signature, date, and an office-use footer.