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LET'S BUILD YOUR CLIENT PROFILE
Welcome To Revitalize Pools and Spa
Please answer the following questions so we can best serve you
First Name
*
Last Name
*
Date of Birth
Are you or your spouse a Veteran?
Yes
No
Branch of Service
Please add information regarding your partner (if applicapble)
Do you have a live in Partner?
Yes
No
Partner's First Name
Partner's Last Name
Birthday
Anniversary Date
Phone
Email
Do you have any live in Children?
Yes
No
How Many?
1
2
3
4
5
Child 1 Name
Birthday
Child 2 Name
Birthday
Child 3 Name
Birthday
Child 4 Name
Birthday
Child 5 Name
Birthday
Favorites
Favorite Beverage
Favorite Restaurant
Favorite Band
Favorite Dessert
Do you have any Pets?
Yes
No
How Many?
1
2
3
4
5
Pet Name and Type
Pet Name and Type
Pet Name and Type
Pet Name and Type
Pet Name and Type
About your pool
Number of Gallons
Pool Type
Salt
Chlorine
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Is your pool covered?
Yes
No
Anything else you would like us to know?
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