Bottle Drop Upload

IMPORTANT: If uploading a bottle drop survey or a lead slip from a "Water Sample Canvassing" approach, make sure to actually TEST the water with OTO, then IF chlorine is present write a big Cl before taking the picture. IF no Cl, write NO Cl on the form in large, noticeable print prior to uploading.

Marketer Name * Required

YOUR NAME OR NAME OF THE ENTITY WHO GENERATED THE LEAD

Lead Source Type * Required

Name * Required

BOTH THE FIRST & LAST NAME OF PRIMARY CONTACT (JOHN SMITH)

Co-Owner First Name

LEAVE BLANK IF UNKNOWN

Co-Owner Last Name

LEAVE BLANK IF UNKNOWN

Phone

10 DIGITS W/ AREA CODE. (NO PHONE # = NOT A GOOD LEAD).

IF KNOWN, OTHERWISE LEAVE BLANK

Address * Required

Housing Type * Required

Do they OWN the or rent the home? * Required

Water Source Type * Required

# Adults In Household * Required

Age Group of Primary Adults * Required

# Kids In Household * Required

Initial Rating of Water Quality * Required

Any Conditions Experienced?

Chlorine Smell

Sulfur Smell

Other Odors

Cloudy Water

Water Spots

Foul Taste

Gunk/Buildup

Other

Does Anyone In Home Have Eczema or Dry Skin? * Required

Has or Uses...

Fridge Filter

Sink Filter

Berkey or Similar

Reverse Osmosis

NON R.O. Undersink

Water Softener

Whole House Filtration

Unknown / Left Blank

Avg. Monthly Spend on Groceries & Supplies * Required

Monthly Bottled h2o Spend? * Required

Avg. Amount Spent Annually on Fridge Filters * Required

ADDT'L NOTES ON BOTTLE DROP SURVEY (IF ANY)?

...THAT WERE WRITTEN BY THE HOMEOWNER?

Marketer Notes

ANY OBSERVATIONS / DETAILS WORTH US KNOWING?

UPLOAD- Lead/Appt./Bottle Drop Slip

IF YOU SPOKE BY PHONE, FILL OUT APPT. SLIP, LEAVING APPT. TIME BLANK, AND UPLOAD THAT (OR ANY DOCUMENT THAT HAS YOUR NOTES FROM THE CONVERSATION OR CUSTOMER DETAILS).