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Wayfair Lead Form

In Home Consultation

What is your First and Last name?

Verify spelling

What is the project Postal Code?

The list of Products / Services include Only
those offered in the indicated Zip Code.

And what product are you interested in?

If Tile, ask where it is being installed.
If "outside", Direct Connect with Affiliate.

If Tile and Wood: "We'll try to find 1 Contractor for both, but may need to assign 2 Contractors."

Can you confirm the Store that you shop in?

Select a different store if applicable.

Can I have your email?

If they object: We need your email so we can send updates and give you access to My Projects, your customer portal, where you can manage the project yourself.

Complete the field below ONLY if Customer requests a specific installation date.


What is the street address for the project?



Confirm City; Select a different City if needed.

Is your billing address the same as the project address?

Would you like receive updates about your project and occasional promotional messages via text?

If Yes: "Great, thanks. These may be sent using automated systems and message and data rates may apply. You can opt out at any time by texting STOP."

If No: “Thank you, updates about your project will come via email instead.” Uncheck the box.

Thank you. Before I submit your request, do you have any other questions?

You should receive a call from a Provider within the next 48 business hours to schedule your appointment.

We look forward to helping you with your project.