Lead Qualification Form
Please fill out the form below to qualify as a potential lead.
Contact Information
Full Name
First Name
Last Name
Company Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Company Website
How did the lead hear about your company or product?
Website
Referral
Social media
Event
Other
Company Information
Industry
Please Select
Technology
Finance
Healthcare
Education
Retail
Other
Number of Employees
Please Select
1-10
11-50
51-100
More than 100
Annual Revenue
Please Select
Less than $1 million
$1 million - $5 million
$5 million - $10 million
More than $10 million
Budget for Solution
Please Select
Less than $10,000
$10,000 - $50,000
$50,000 - $100,000
More than $100,000
Lead's Role
Job Title/Position
Department
What challenges or pain points is the lead currently facing that your product or service can address?
Does the lead have a budget allocated for the solution you provide?
Yes
No
If yes, what is the estimated budget range?
Does the lead have a specific timeline for implementing a solution?
Yes
No
If yes, what is the timeline?
Does the lead have the authority to make purchasing decisions?
Yes
No
If no, who in their organization has the authority?
Is the lead currently using a similar solution or service?
Yes
No
If yes, who is their current provider, and what are the reasons for considering a change?
Is the lead aware of your competitors and their offerings?
Yes
No
If yes, which competitors are they considering or comparing to your product or service?
Please provide any additional details or comments that may be relevant for lead qualification
Lead Qualification Status
Qualified
Not Qualified
Needs Further Nurturing
Next Steps
Schedule a sales call/demo
Send additional information or resources
Add to email nurturing campaign
Other
Assigned Sales Representative Name
First Name
Last Name
Email
example@example.com
Date of Lead Qualification
-
Month
-
Day
Year
Date
Submit
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