Credit Repair Onboarding Form

Client Intake Form

Please complete the form below to get started.

1. Personal

2. Address

3. Monitoring

Submission Complete ✅

Thank you! Your intake form has been submitted successfully.

Our team will review your information and follow up with the next steps.

First Name

Last Name

Email Address

Phone Number

Date Of Birth

Social Security Number

Current Address

City

State

Zip Code

If you do not have credit monitoring:
MyFreeScoreNow: Enroll
SmartCredit: Create

Need CFPB? Create Login

Select Your Monitoring Agency

Monitoring Username

Credit Monitoring Password

CFPB Login