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Uprise Innovations LLC

CLIENT INTAKE WAIVER & CONSENT FORMS

Note:

PLEASE ANSWER THE FOLLOWING QUESTIONS SO THAT I MAY HAVE A BETTER UNDERSTANDING OF YOUR ENTERTAINMENT NEEDS.

Date

Name

Last Name

Phone No

Address

City

Zip Code

How did you hear about us?

What cable / Internet services are needed for your home ?

How many TV’s will you be setting up ?

Have you ever used Uprise Innovations llc for your entertainment needs ?

Yes No Other

Do you consent Uprise Innovations Llc or their affiliates to contact you to determine your entertainment needs ?

Yes No

Is there any additional information I should know before we begin your service?