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AFFILIATE QUESTIONNAIRE
REFERRAL SOURCE
How did you hear about us? Store Associate
AffiliateWebsiteNWFAEmail/FlyerOtherWhich Retailer referred you?CONTACT INFORMATION
Company Name
Company Address
CityStateZIPContact
Office
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How to fill out referral source
How to fill out referral source
01
Start by entering the name of the referring party.
02
Include the contact information of the referring party such as phone number and email address.
03
Note down the date of the referral.
04
Provide details about the reason for the referral and any specific instructions or information that need to be shared.
05
Make sure to obtain any signatures or consent required for the referral.
Who needs referral source?
01
Healthcare providers who are referring patients to other specialists or facilities.
02
Social workers who are connecting individuals to community resources or support services.
03
Employers who are recommending employees for job opportunities or additional training programs.
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What is referral source?
Referral source is the channel or method through which a customer or client was directed to a particular business or service provider.
Who is required to file referral source?
Any individual or organization that receives referrals and wants to track where their clients are coming from is required to file referral source.
How to fill out referral source?
Referral source can be filled out by documenting the source of each referral, such as word of mouth, website, social media, etc.
What is the purpose of referral source?
The purpose of referral source is to track the effectiveness of different marketing channels and identify which sources are bringing in the most clients or customers.
What information must be reported on referral source?
Information such as the name of the referral source, contact information, and any additional details about how the referral was made should be reported on referral source.
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