Referral Request Form
US Letter · 8.5 × 11 in
HLP
Harvey L. PhelpsExecutive Advisory
Referral Request
REF · 2026-XXX

A Quiet Introduction.

With your permission, I would like to invite one or two people from your network into a conversation. This form captures who — and how you'd prefer the introduction to be made.
Referring Client
_______________________________________________
Date
_____________________, 2026

Whom You'd Introduce · Person One

Name
Title · Organization
Email
Best way to reach
Why you think they'd benefit from a conversation

Person Two (optional)

Name
Title · Organization
Email
Best way to reach
Why you think they'd benefit

— With deep appreciation. A quiet introduction from you carries more weight than a hundred cold outreaches.

MMXXVI · Volume II · 31
Prepared by RJ Business Solutions