Online Customer Referral
With Base Theme

"Customer Referral Form Template"

Streamline Your Website with This Simple Form Addition!
Online Customer Referral Form Template

Leveraging the power of word-of-mouth has never been easier with our Referral Submission Form. Designed to facilitate the process of referring new clients to your business, this form is a key component in expanding your customer base and rewarding loyal clients for their recommendations.

This user-friendly form is segmented into two clear sections: Referrer Information and Referral Details. Starting with the basics, the referrer is prompted to provide their contact information. This ensures that you can acknowledge their contribution and maintain a strong relationship with them.

Moving to the Referral Details, the referrer can input the name, email, and phone number of the person they are introducing to your business. This straightforward approach ensures that you receive all the necessary information to make a warm introduction and offer your services.

An optional field for additional comments or notes is included to capture any relevant information or personal endorsements that might assist in the referral process.

This online form simplifies the referral submission to just a few clicks, encouraging your satisfied customers to actively participate in the growth of your business network. By implementing this form on your website, you're not just making it easier for customers to refer others, you're also setting the stage for increased engagement and future business opportunities.

Online Customer Referral Features

Boost Referrals Effortlessly
Boost Referrals Effortlessly
Empower clients to refer new customers seamlessly while rewarding loyalty.
Streamline Referral Process
Streamline Referral Process
Efficiently collect and organize referral information for quick follow-ups.
Enhance Customer Engagement
Enhance Customer Engagement
Encourage satisfied customers to actively participate in business growth.
Maximize Business Network
Maximize Business Network
Expand your customer base by leveraging the power of word-of-mouth referrals.
Reward Customer Advocacy
Reward Customer Advocacy
Acknowledge and incentivize loyal clients for recommending your services.
Simplify Referral Submission
Simplify Referral Submission
Make it easy for customers to refer others with just a few clicks.
Online Customer Referral Form Template
Customizable Form Fields
You can add, remove or re-arrange form fields when using our form builder app.
title (html-block)
referrer_info_subtitle (html-block)
referrer_name* (text, input)
Your Name
referrer_email* (email)
Your Email
referrer_phone* (phone-number)
Your Phone Number
referral_details_subtitle (html-block)
referral_name* (text, input)
Referral's Name
referral_email* (email)
Referral's Email
referral_phone* (phone-number)
Referral's Phone Number
additional_comments_subtitle (html-block)
additional_comments (text, textarea)
Additional Comments

Try Out the Form for Yourself!

Experience Ease and Flexibility Across Multiple Devices and Screens

The form below is using our "Base" form theme. You can change the colors and the theme using the Wizara Form Builder app.