1. Feedback Report Form
Customer Information:
Agent’s Name: ______________________________________________________
Lead Type Purchased: ______________________________________________________
Appointment Date and Time: ________________________________________________
Prospect Information:
Prospect’s Full Name: _____________________________________________________
Street Address:____________________________________________________________
City, County, State, Zip: ____________________________________________________
Phone Number: _____________________________________________________________
Appointment Feedback Comments
To report your feedback of your appointments please send this report within 24 hours of receiving your
lead/appointments. Please email to: jason.lewis@newlead.org or you can fax it to Office: Fax: (214) 572-7106.
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NEW LEAD Quality Control Department Use Only:
Date Notified: _________________ Replaced: _________________
Date Completed: _________________ Not Replaced: _________________