Coach Dibbs Credit Club — Client Intake Form

Which Plan Did You Purchase?

Silver

$797

Gold

$997

Platinum

$1,497

Please select your plan.

Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

Date of Birth *

Social Security Number *

Your SSN is required to pull your 3-bureau credit report and submit disputes on your behalf. This information is encrypted and used solely for credit repair services.

Home Address

Street Address *

City *

State *

Zip Code *

Your Primary Goal

What Are You Working Toward? *

Current Score Range (Estimate)

Anything Else We Should Know?

✅

You're Activated.

Your intake is complete. Your specialist has been notified and will begin reviewing your credit profile within 24 hours.

What Happens Next

1 Your 3-bureau credit report will be pulled and reviewed

2 A custom dispute strategy will be built for your profile

3 You'll receive your portal login credentials within 24 hours

4 Disputes will begin across Equifax, Experian & TransUnion

5 Monthly progress reports will be sent to your email

One last step — set up your credit monitoring so we can track your progress in real time.

Set Up My Credit Monitoring →

CLIENT INTAKE FORM

You're Activated.

What Happens Next