Debt consolidation inquiry form template
This six-step debt consolidation form asks the types of debt, the total owed, employment status, timing and any notes, followed by the contact details. You can clone it into your Growform account and add a consent checkbox.
What the form asks, step by step
Consolidation depends on the kind of debt, the amount and the borrower’s income, so those come first. Timing then shows who is ready to act now.
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Step 1: “What type of debts do you have?”
Several debt types can be selected, from credit cards to medical bills.
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Step 2: “How much is your total debt?”
Bands up to more than $10,000 show which consolidation products may apply.
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Step 3: “What is your employment status?”
Income source affects loan eligibility and the options an adviser can offer.
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Step 4: “How soon do you want to consolidate your debts?”
Immediate cases get a callback first, and undecided borrowers get information.
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Step 5: More information
Borrowers can mention missed payments or letters from creditors.
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Step 6: “How shall we contact you?”
Name, email and phone come last.
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After submitting
Borrowers see a basic thank-you, and a lender or adviser should replace it with a callback time and required disclosures.
Who it’s for
Debt consolidation lenders, credit counseling agencies and financial lead generators use this debt consolidation questionnaire on landing pages. It collects the debt mix, the amount and the borrower’s situation without asking for account numbers, so people feel comfortable starting. Advisers can match the borrower to a loan, a management plan or a referral before the first call. The full debt consolidation application, with income checks and credit history, follows with the lender.
Why this structure converts
- The multi-select debt question lets borrowers describe a complicated situation with a few taps.
- Debt totals are ranges, which feels less exposing than typing an exact figure.
- Timing comes after the financial questions, when the borrower has already described their situation.
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Raise the debt bands
The top band is “More than $10,000”, which covers most consolidation cases. Add bands for $25,000 and $50,000 to separate larger debts.
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Add consent and certification
Add a consent checkbox to the contact step and turn on TrustedForm if you share leads with lenders.
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Branch on unemployment
Use conditional logic to show debt advice resources to unemployed borrowers, who may not qualify for a loan.
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Frequently asked questions
Is this a debt consolidation application?
No. It is a first-step inquiry that qualifies the borrower. The lender’s application, with credit checks and income proof, comes next.
Can I sell or share these leads?
Yes, with recorded consent. Add a consent checkbox and TrustedForm or Jornaya certification before passing leads to partners.
Which tools does it connect to?
Growform sends inquiries to Credit Repair Cloud, FLG, Salesforce, HubSpot and other tools.
What happens next?
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Step 1: Clone this form template
Clone this template into your Growform account (create one first if you don’t already have one). -
Step 2: Edit your form
Get creative and adjust your form's theme options, questions or layout in the Growform form builder. -
Step 3: Share or embed your form
Share a link to your form, or embed it in your existing website. Receive new submissions by email or send them to 7,000+ apps via Zapier.
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