Initial Interview Form

Initial Interview

Contact Info

First Name *

Last Name *

Phone

Email *

MUST be email used at scheduling.

State *

Recruiter Info

Recruiter Assigned at Scheduling *

Recruiter at Time Lead Closed/Won

Penny Wilson
Norman Gordon
Nichole Burrows
Fred Bender
Jen Bishop
Mike Morice
Guy Jean
Brenda Osberg
Diane Lampe
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Initial Interview Outcomes

Initial Interview Notes

Get Started - Fast Track

WON - GET STARTED

WON - GET STARTED (Fast Track)

Licensed & Contracted - Check to Register them for New Agent Quick Start

Looks like they are BOTH Licensed & Contracted. Check to Register them for New Agent Quick Start

** When form is submitted - this will kick off the New Agent Onboard process

Licensing

Are They Licensed? *

Yes

No

Are They Contracted? *

Yes

No

Do They Have A Life Insurance License? *

Yes

No

Do They Have a Health Insurance License? *

Yes

No

If not Life/Health licensed - are they willing to get licensed? *

Yes - Life

Yes - Health

No - Not interested in getting life/health licensed

Have They Completed The Annual Agreement?

Yes

No

NAA

Do They Have An NAA Number?

Yes

No

NAA Number:

Rescheduling

Rescheduled Interview On The Call

Check If They Rescheduled On The Call (Only Check If You Rescheduled Them)

Other Outcomes

Other Interview Outcomes - Not Closed

No Showed Interview - Check to Re-Schedule

Not Interested

Cancelled - Check ONLY if the notified you they needed to cancel

Prospect Follow Up

Consult Completed - Setting Follow Up/Callback Date

Prospect Next Action Follow Up Date

Prospect Next Action Follow Up Notes

Follow Up Completed - No Progress Made