Secure intake for FreezeReports.com freeze and report request packages.
Secure Intake Form

Let’s gather the details needed to prepare your freeze requests correctly.

This intake is designed to collect the personal information commonly needed to prepare request letters for alternative consumer reporting agencies before secure checkout.

Collects current address and prior address history for the last two years
Collects the personal information needed before secure checkout
Built for CRM import, mail merge, and credit repair software population

What happens after intake

Your CRM can tag the lead, connect the checkout step, and populate your letter workflow automatically.

  • Lead enters system New Intake
  • Intake is completed Ready for Checkout
  • Data maps to letters 10 Agencies
  • Payment status tracked Cart / CRM
  • Documents stored securely Verification
Start Below

FreezeReports.com Secure Intake

Use this version of the intake page so clients complete their personal information first, then continue to checkout to choose and pay for the service package.

Important: because this process may require sensitive information such as date of birth, Social Security number, and address history, the live version should be connected to a secure, encrypted form platform and clear privacy disclosures before launch.

1. Basic Contact Information

These fields create the core CRM record and give you the contact points needed for updates.

2. Identity Verification Details

These are commonly needed to prepare letters and identify the correct consumer file with each agency.

Use a secure live form for this field before launch.

3. Current Mailing Address

This is the primary address to use in letters and the place where agencies may mail report responses.

4. Prior Address History — Last 2 Years

Use these fields for former addresses during the last 24 months. This is important because different files may still be indexed under older addresses.

5. Delivery and Contact Preferences

Helpful for your operations and for how you communicate updates with the client.

6. Identity Documents Upload

Many agencies require proof of identity and/or proof of address. Your live workflow can require uploads or trigger a follow-up request depending on the package.

Accepted examples: utility bill, bank statement, lease, or similar proof of current residence.

7. Agency Scope and Service Authorizations

These checkboxes help define consent, service scope, and operational handling. Your attorney/compliance review should finalize this section before launch.

8. Internal CRM / Automation Fields

These can be hidden fields in production, but I’m showing them here so the structure is crystal clear for your workflow.

View Packages First
This version uses normal browser validation before moving to checkout.html.

Built for quick sign-up

The structure is clean enough for conversion but detailed enough to support your operations and mail-merge workflow.

Designed for cleaner flow

Clients complete personal information here, then select the actual package and payment option on checkout.html.

Natural bridge to BCR

Once reports arrive, this intake can lead into a review call, credit cleanup conversation, or premium follow-up service.