New Client Intake Form | Nica's Platinum Credit Solutions

To begin the credit repair process, an active credit monitoring account is required.

After you submit this client intake form, I will personally send you instructions on how to create your credit monitoring account. Once completed, your credit file will be transferred into my system and work will begin.

Name *

Email address *

Phone *

Date of Birth *

Current Address *

Credit Goals *

Authorization *

I authorize Nica's Platinum Credit Solutions to review my credit information for analysis and dispute purposes.