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Easy Collection: The Must-Have List for Intake Forms

Collecting on unpaid bills is difficult, but it’s especially so when you realize you don’t have the customer’s most recent contact information. To help guard against potential collection problems, be sure your intake forms include all nine of the following:

1. Full name with middle initial for both customer and spouse. No nicknames.

2. Street, city, and ZIP code.

3. Social Security numbers for both customer and spouse. There are many people with the same name. SSN gives positive identification.

4. All phone numbers (home, work, and cell) for customer and spouse. IMPORTANT: For the cell phone, include a permission box for them to check allowing you or any agent of your office to use.

5. Employment information for both customer and spouse. Include company name, address, phone number and occupation. This is important if the account is sent to collections, refuses to pay and litigation is pursued.

6. Insurance and license information. Make copies of any insurance cards or other forms of identification such as a driver’s license or passport.

7. Email address with a permission box allowing you or any agent of your office to use it. Email is very fast becoming the preferred method of contact, especially with younger customers. Due to the privacy act, getting permission is necessary.

8. Nearest friend or relative not living with them. You’ll need name and phone number. This is needed if the customer moves without a forwarding address or phone number.

9. Date of birth. This helps for positive identification.