Full name
Email
Phone
Booking for 30-Minute Session60-Minute Session
Are you currently insured with a life insurance policy? YesNo
Do you currently own a home? YesNoIn the process of buyingPrefer not to say
What is your age range? Under 2525-3435-4445-5455+
How many dependents or family members do you support financially? Just myself1-25 or morePrefer not to say
What is your main reason for exploring life insurance? Family protection (e.g., income replacement)Wealth-building strategy (e.g., cash value policies, legacy planning)Estate planning or tax strategyBusiness or key-person insuranceOther - please specify:
What specific questions or concerns do you have about life insurance?
Type of mediation needed: Co-parenting or family agreementsRoommate or housing issuesFriend or interpersonal conflictOther:
Is the other party aware of your interest in mediation? YesNoUnsure
Preferred mediation format: VirtualIn-person (Atlanta area only)
Briefly describe the issue or reason for mediation:*
What would you like to achieve through this process? (optional)
Basic Information :
Full Name *
Email *
Mobile *
Preferred Contact Method WhatsAppPhone CallText MessageEmail
Are looking to?* Rent a homeBuy a homeNot Sure yet / Exploring both options
Location & Timeline
Which cities are you open to? Playa del CarmenTulumCancúnCancúnPuerto MorelosCozumelNot sure – need guidance
When are you looking to move or make a purchase? Move-in or Purchase Timeline
Is this your first time living or buying in Mexico? YesNo
Rental Question
Rental term you’re looking for: 1–3 months4–6 months6–12 monthsLong-term / 1+ year Must-have features: Fast Wi-FiFurnishedPoolPet-FriendlyWalkable AreaSecure AccessGymParkingOther:
Monthly rental budget (in USD or MXN)*:
Preferred type of rental: Studio1 Bedroom2 Bedrooms3+ BedroomsLuxury / PenthouseOpen to options
Buyer Questions
Budget range for your home purchase (USD or MXN)*:
Are you financing or purchasing in cash? CashSeeking financingNot sure yet
Preferred property type: CondoHouseLandInvestment PropertyVacation HomeOther:
Desired home features: PoolOcean viewNew constructionGated communityNear beachRooftop accessOther:
Agent
Contact Information :
Preferred Contact Method Phone CallText MessageEmail
What brings you here today? * I’m looking to buy a homeI’m looking to sell a homeI’m a real estate agent interested in joining your national network
Buyer Intake Form :
Where in the U.S. are you looking to buy? *
When are you planning to buy? ASAPIn 1–3 monthsIn 4–6 monthsIn 6–12 monthsJust browsing
Budget range (USD):
What type of property are you looking for? Single FamilyCondo/TownhomeMulti-FamilyInvestment PropertyLandOther:
Will you be financing or paying cash? FinancingCashNot sure yet
Are you currently working with an agent? YesNo
Top priorities for your new home: *
Seller Intake Form :
Where is your property located? *
Is the property currently listed? YesNo
Estimated property value (if known):
Are you currently working with a listing agent? YesNo
When are you planning to sell? ASAPIn 1–3 monthsIn 4–6 monthsLater this year
Any upgrades or unique selling points?
Prefjerred Contact Method Phone CallText MessageEmail
What brings you here today? * I'm looking to buy a homeI'm looking to sell a homeI'm a real estate agent interested in joining your national network
Agent Intake Form :
Are you a licensed agent? YesNo
Where are you licensed?
Years of experience:
Open to: Buyer referralsSeller referralsStrategic partnerships
Brokerage name:
Link to your agent profile or website (optional):
Upload your headshot or business card (optional):
