Mortgage refinance form template
Refi shoppers want a number, not a form. This template trades the payoff, "see my savings," for qualification data step by step, and only asks for contact details once the prospect is invested. Address enrichment fills in property data your loan officers would otherwise chase.
Opens in the builder, ready to publish
Describe changes and AI rebuilds it your way
Open it on your phone. Links to the live demo funnel, not this page.
What's inside this template
Eight steps ordered so qualification happens before commitment. Contact fields come last, after the engagement questions, which is the ordering behind the platform's 34% average conversion lift.
- 1
Property address
Address autocomplete verifies the property exists and pulls estimated value data, so the savings math at the end is grounded in the actual home.
address_autocompleteproperty_enrichment - 2
Refinance goal
Lower payment, cash out, or a shorter term. Intent your buyers pay more for, captured in one tap.
intent_capture - 3
Loan type
Conventional, FHA, VA, or jumbo. The answer decides which lender or campaign the lead routes to.
conditional_routing - 4
Home value and balance
A slider for estimated value and ranges for remaining balance. No typing on a phone keyboard, and the ranges size the loan for your buyers.
range_sliderbuyer_qualification - 5
Credit band
Self-reported credit range routes sub-620 traffic to the buyer who wants it instead of burning your premium ones.
conditional_routing - 6
Employment and current rate
Employment status and current rate round out the file a loan officer needs before the first call.
buyer_qualification - 7
Contact details, last and verified
Name first, then email and phone, each verified in real time while the visitor is still on the page.
email_verifyphone_verifycontact_scoretcpa_consent
Built to deliver qualified leads
Same ad spend. Capture 2X the qualified leads. For refi funnels that means the same Google Ads budget produces twice the files your officers can actually call. Funnels on the platform average a 34% conversion lift, and every lead arrives verified before it reaches your CRM.
More accepted, paid leads
Real-time email and phone verification plus Contact Score turn the same traffic into files your buyers accept and pay for.
Lead verification →Routes itself
Credit band, loan type, and balance branch each lead to the right buyer or campaign, sub-second.
Distribution & routing →Compliance is in the layout
Consent placement and disclosure copy follow mortgage-marketing rules, so legal reviews the template once, not every campaign.
Lead gen compliance →Mortgage compliance notes
What this template handles for regulated mortgage marketing:
- TCPA consent language positioned above the submit action, unbundled from the marketing opt-in
- TrustedForm and Jornaya certificate fields supported without custom code
- State-aware disclosure block placement on the final step
More for mortgage
Mortgage Pre-Qualification Form
Purchase-focused pre-qualification with loan-type branching and document-readiness signals.
MortgageVA Home Loan Form
Branch of service, benefit usage, and timeline steps that confirm VA eligibility before the contact ask.
Real EstateHome Value Estimate Funnel
Address-first instant-value hook that turns curiosity about price into a seller lead.
Frequently asked questions
Can I change the steps or fields?
Everything is editable in the builder. Or press Generate your version, describe the change, add a HELOC branch for example, and AI rebuilds the template with it.
What counts as a qualified refinance lead?
A qualified lead is one with a verified email, a verified phone, enriched data, and a Contact Score above your threshold, checked before the visitor leaves the page. That check runs on this template's final step, before the thank-you page loads.
Where do the leads go?
Native delivery into LeadProsper, LeadByte, Phonexa, HighLevel, and 10+ others, or any CRM via webhook. Sub-second, with retry logic.
Does the address lookup slow the page down?
No. Autocomplete resolves as the prospect types, and published pages hold 90 to 100 Lighthouse scores with sub-200ms loads.
Go deeper on mortgage lead gen
Start capturing qualified refi leads
Use this template as is, or describe your version and let AI build it.