Client Care – Early Inquiry Tracker

Early Inquiry Tracker

-->If you are logging an inquiry that does not have an email address, use the first name and last name of the Prospect as the email address.
--> For example "John Doe" would be "johndoe@mwn.com" .

-->When we obtain the correct email address, update the Email field in the Contact record.

Client Care Team Member

Early Inquiry Method*

Is this for you or someone else?

Myself

Someone else (parent/guardian on behalf of child)

I am making a referral for my client or patient

Not Sure

First Name

Last Name

Email*

Phone

Parent/Guardian's First Name

Parent/Guardian's Last Name

Current Age

What service(s) are you seeking?*

Early Inquiry Notes

Insurance Provider