Client Referral Form

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To facilitate this, we begin by filling out this form and in agreement that the information given here will be used to reach out to you and the referred clients.

BPMC is committed to protecting your privacy and ensuring that all personal data collected are processed according to the principles of transparency, legitimate purpose, and proportionality pursuant to R.A. 10173 (Data Privacy Act of 2012).

Email *

Name of the Referral partner *

Mobile# of the Referral partner *

GCASH # of the Referral partner *

Company Name of the Potential Client *

Contact Person of the Potential Client *

Contact Number of the Potential Client *

Address or Location of the Potential Client - NA if none yet *

Email address where to send the proposal *

Estimated Amount of Proposal (NA if no idea on price) *

Select Lead Category *

Warm - High Chance of Closing

Hot - Partner will facilitate in closing

Your suggested Action to BOAZ *

Call immediately - I told them you would call

Schedule an Ocular Inspection

Schedule a meeting

Attend the meeting I have set (For Hot Clients)

Wait a call from them, I have give them your number

Required

Type of Problems *

Termite

Cockroaches

Sanitary Permit

Mosquitoes

Cleaning and Handyman Repairs

Cleaning Supplies

Required

Target Date of Treatment *

YYYY

Priority *

Very Low

Very High

More details

Send me a copy of my responses.

Submit

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