Lead Capture Form template
Qualify inbound leads with company size, budget and timing before sales follows up.
Free • 7 questions • Fully customizable
1. Full name
Open text response
2. Work email
3. Company
Open text response
4. Company size
- Just me
- 2–10
- 11–50
- 51–200
- 201–1,000
- 1,000+
5. What is your budget for this?
- Under $1,000
- $1,000–$5,000
- $5,000–$20,000
- Over $20,000
- Not sure yet
6. When are you looking to start?
- Right away
- Within a month
- Within 3 months
- Just researching
7. Anything else we should know?
Open text response
Why use this form template?
The Lead Capture Form template gives you a proven starting point so you can launch faster. Every question is editable, responses are unlimited, and you can share by link or QR code in minutes — all free.
Template questions
Yes. The Lead Capture Form template is completely free to use, with unlimited responses and no credit card required.
Absolutely. Every question is fully editable — add, remove, reorder, and reword questions, change answer options, and adjust settings before you share.
Once you customize the template, share it with a link or QR code. Respondents can answer on any device with no sign-up required.
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Start building for free in under a minute
No credit card. No trial limits. Unlimited surveys, quizzes, polls, and responses — all free.