2-minute door survey · No selling · Just gathering data.
0
Today
0
All Time
0
Hot 🔥
JD
Agent
Zone: —
Canvasser
Step 1 of 7Address
Step 1
What's the address here?
Enter the address visible on the property
Step 2 of 7Contact Info
📋 Say to resident: "We're conducting a free home services survey for our neighborhood research program. No obligation whatsoever — we just want to learn about homeowner preferences and match you with local providers if you choose."
Step 2
Resident contact info
Used only for provider follow-up if requested
Step 3 of 7Service Interest
Step 3
Which home services are you thinking about?
Select all that apply — no commitment required
✓
🪵 Flooring
✓
🪟 Windows
✓
🏠 Siding / Exterior
✓
🏗️ Roofing
✓
🧱 Concrete / Driveways
✓
🌿 Landscaping / Lawn
✓
🐛 Pest Control
✓
❄️ HVAC / Heating
✓
🌧️ Gutters
✓
🎨 Interior / Exterior Paint
✓
☀️ Solar Panels
✓
🔐 Home Security
Step 4 of 7Timeline & Budget
Step 4a
When are you looking to get this done?
ASAP
1–3 months
3–6 months
6–12 months
Just exploring
Step 4b
Rough budget in mind?
💵
Under $1K
💵
$1K–$5K
💵
$5K–$15K
💵
$15K+
🤷
Not sure
Step 5 of 7Home Info
Step 5a · Home Age
How old is the home?
🏗️
Built <10 yrs
🏡
10–30 yrs
🏠
30–50 yrs
🏚️
50+ yrs
Step 5b · Home Size
Approximate square footage?
📐
Under 1,200
📐
1,200–2,000
📐
2,000–3,500
📐
3,500+ sq ft
Step 5c · Interest Level
Interest level 1–5?
1 = just curious · 5 = ready to act now
Step 6 of 7Field Notes
Step 6
Canvasser observations
Property condition, resident attitude, any visible needs
Step 7 of 7Consent & Signature
Step 7 · Required
Resident Consent & Authorization
Please read to resident and obtain signature
Liberty Analytics — Data Collection Consent Form
By signing below, I the resident voluntarily consent to participate in this home services survey conducted by Liberty Analytics. I understand that:
(1) My contact information and survey responses will be stored in Liberty Analytics' secure database and may be shared with licensed home improvement and services contractors for the purpose of receiving quotes or information about services I have expressed interest in.
(2) I am under no obligation to purchase any product or service as a result of this survey. Participation is entirely voluntary.
(3) I may request removal of my data at any time by contacting Liberty Analytics at the information provided by the canvasser.
(4) This is a survey for data and lead generation purposes only. The canvasser conducting this survey is not making any sales representations or commitments on behalf of any contractor.
(5) My information will not be sold to telemarketers or spam lists. It will only be shared with pre-screened, licensed home service providers.
✍️ Resident Signature
Account Settings
👤 Identity
Username
—
Role
—
✏️ Profile
✓ Profile updated successfully.
🔒 Change Password
✓ Password updated successfully.
✅
Lead Captured!
Survey submitted, scored, and pinned to your territory map.