Lead Name:

Company:

Email:

Phone Number:

Lead Source:

• Website

• Social Media

• Referral

• Event/Trade Show

• Email Marketing

• Other: ____________

Yes

No

Pending

Budget:

Authority:

Need:

Timeline:

• Urgent

• Within 3 months

• Within 6 months

• Longer than 6 months

• Not specified

Specific Needs/Pain Points:

Additional Information:

Action Required:

• Send Follow-up Email

• Schedule Phone Call

• Arrange Meeting

• Send Marketing Collateral

• Other: ____________

Date for Next Action:

Assigned To:

Status:

• New Lead

• Contacted

• Qualified

• Won

• Lost

• Other: ____________

Date:

Time: