Intake Form Plugin

Test drive this form to see if something like this might work for you.

I consent to my submitted data being collected and stored*
- Yes
Name*
First Last
Email*
Enter Email Confirm Email
Date
MM slash DD slash YYYY
Website URL*

example: marynasmuts.com
Website Hosting*
Tell me where your website is hosted
Website Hosting if "Other"

Please tell me where your website is hosted if you chose "Other" from the dropdown list above.
WordPress Theme

okay to leave this blank if you don't know
Tell me about the pre-work or input form you'd like to automate
Describe how you currently manage this information and what some of your biggest issues are.
Would you like me to get back to you?*
- Yes
- No

Click here to get back to Automated Intake Forms.