Customer referral form template
This five-step customer referral form asks who is being referred, how to reach them, what they need and how you know them, followed by the referrer’s details. You can clone this template into your Growform account and add your reward.
What the form asks, step by step
The person being referred comes first, and the customer who refers them comes last. Two answers are typed and two are chosen from buttons.
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Step 1: “What is the name of the person you are referring?”
Starting with the friend’s name keeps the customer focused on the introduction.
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Step 2: “What is their phone number or email address?”
One field accepts either a phone number or an email address.
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Step 3: “What do they need help with?”
Your team knows whether to prepare a quote or book a consultation.
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Step 4: “How do you know them?”
Knowing the relationship helps your team open the first call naturally.
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Step 5: “What are your details?”
Name, email and phone come last.
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After submitting
The customer is thanked for the referral and told that you will contact the person soon, and you can add details of any reward.
Who it’s for
Service businesses that grow through recommendations use this form on a referral page or in an email to existing customers. It works equally well as a refer a friend form for a home services company, a gym or an agency. Each submission gives you the new person’s name, a way to reach them, what they need and who sent them. Your team can then make the first call with a proper introduction and credit the right customer afterwards. The form records the referral only, so any reward is decided and paid by your business.
Why this structure converts
- The form opens with the friend and not with the customer’s own details, which keeps the purpose clear.
- A single contact field accepts a phone number or an email, so the customer can share whichever they have.
- The need and relationship questions are buttons, which makes the second half of the form quick.
- The referrer’s details come last, when the introduction is already complete.
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Make it yours
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Add a consent question
Add a checkbox asking the customer to confirm that the person has agreed to be contacted.
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Explain the reward
State the reward on the thank-you screen or above the first question, so customers know what they receive when the referral becomes a sale.
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List your own services
Replace the four needs with the services you sell, which lets each referral reach the right member of the team.
Frequently asked questions
What should a referral form template include?
It should collect the referred person’s name and contact details, what they need, and the name of the customer who referred them. This template also asks how the two know each other.
Does the form track rewards?
No. The form records who referred whom, and your team or your referral software decides when a reward is due. You can connect the form to Referral Rock or a Google Sheet to keep that record.
Can employees or partners use it?
Yes. Change the relationship options to colleague, supplier or partner, and the same form works for staff and partner referrals.
Can one customer refer several people?
Yes. Each submission covers one person, and a customer can complete the form again for every new referral.
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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