Generate a free splitforms key
Sign in at splitforms.com — your access key is created instantly. No credit card, no setup wizard, no SDK to install.
Quote Request · React
Lead-capture form for agencies, freelancers, and service businesses. Free for 500 submissions total — no backend, no SDK, no plugin.

Copy-paste code
Replace YOUR_ACCESS_KEY with your splitforms key, paste into a React page, and ship. No build-time integration required.
'use client';
import { useEffect, useState, type FormEvent } from 'react';
export default function QuoteForm() {
const [status, setStatus] = useState<'idle' | 'sending' | 'sent' | 'error'>('idle');
// splitforms tracker (drop-off analytics + partial leads), loaded once. It
// finds the form by data-sf-key and adds a hidden sf_sid field to it.
useEffect(() => {
const src = 'https://splitforms.com/embed.js';
if (document.querySelector(`script[src="${src}"]`)) return;
const script = document.createElement('script');
script.src = src;
script.async = true;
document.body.appendChild(script);
}, []);
async function onSubmit(e: FormEvent<HTMLFormElement>) {
e.preventDefault();
setStatus('sending');
// Capture the form now: React clears e.currentTarget once the handler
// yields at the first await, so calling e.currentTarget.reset() later throws.
const form = e.currentTarget;
const data = new FormData(form);
data.set('access_key', 'YOUR_ACCESS_KEY');
data.set('subject', 'New quote request');
const res = await fetch('https://splitforms.com/api/submit', {
method: 'POST',
body: data,
headers: { Accept: 'application/json' },
});
const json = await res.json();
if (json.success && json.payment_url) {
// Payment form: finish the payment on the secure Stripe page.
window.location.href = json.payment_url;
return;
}
setStatus(json.success ? 'sent' : 'error');
if (json.success) form.reset();
}
if (status === 'sent') return <p>Thanks — we’ll be in touch.</p>;
return (
<form data-sf-key="YOUR_ACCESS_KEY" onSubmit={onSubmit}>
<label htmlFor="name">Name *</label>
<input id="name" type="text" name="name" placeholder="Jane Builder" required />
<label htmlFor="email">Email *</label>
<input id="email" type="email" name="email" placeholder="[email protected]" required />
<label htmlFor="phone">Phone *</label>
<input id="phone" type="tel" name="phone" placeholder="+1 415 555 0142" required />
<label htmlFor="company">Company</label>
<input id="company" type="text" name="company" placeholder="Acme Inc" />
<label htmlFor="budget">Budget *</label>
<select id="budget" name="budget" required>
<option value="">Choose…</option>
<option>< $5k</option>
<option>$5k–$15k</option>
<option>$15k–$50k</option>
<option>$50k+</option>
</select>
<label htmlFor="project">Tell us about the project *</label>
<textarea id="project" name="project" placeholder="Goals, timeline, anything we should know." required />
<button type="submit" disabled={status === 'sending'}>
{status === 'sending' ? 'Sending…' : 'Send'}
</button>
{status === 'error' && <p>Something went wrong. Try again.</p>}
</form>
);
}React + Quote Request
React ships nothing for form delivery — it's a view layer. The historical options are an Express server you stand up just for POST /api/contact, a Vercel serverless function with SMTP wiring, or a third-party library like Formik that still leaves the backend problem unsolved. The quote request on this page uses useState for submit state and a plain fetch POST to splitforms — no form library, no context provider, no wrapper component. It works in Create React App, Vite, Remix, and every React bundler because it's just standard FormData and the Fetch API.

Quote Request fields
The posted payload contains name, email, phone, company, budget, tell us about the project. Required fields are name, email, phone, budget and tell us about the project. Rename, remove, or add your own — splitforms accepts any name you POST.

Template playbook
Independent insurance brokers compete with direct carriers (Geico, Progressive, State Farm) and lead-gen platforms (LendingTree Insurance, EverQuote) — the win is speed-to-quote and personal touch. Brokers earn 10-15% commission on auto/home premiums and 50-100%+ on life policies (year-1). The form captures line of business (auto / home / life / business / umbrella / multi-line), current carrier, renewal date, and basic data (driver count / property address / business revenue depending on line). Speed matters: quotes delivered within 4 hours of inquiry close at 35-45%, vs 10-15% for next-day quotes. Webhook into AgencyZoom / EZLynx / Applied Epic so the AMS pre-loads the quote workflow.

Setup
Three actions stand between you and your first quote request submission — no backend, no database, no CAPTCHA library.
Sign in at splitforms.com — your access key is created instantly. No credit card, no setup wizard, no SDK to install.
Drop the form snippet into a React page, component, or layout. Replace YOUR_ACCESS_KEY with the key from your dashboard. The form action is a hard-coded URL — no env vars or build-time wiring needed.
Dashboard updates live on Free. Free includes owner email delivery; paid plans add signed webhooks, CSV export, Slack/Discord forwarding, and BCC to your team.
How SplitForms works
splitforms receives the submission, filters spam, saves it to your dashboard and emails you — then, on paid plans, sends it on to your webhooks and integrations. No backend infrastructure to build.

Point your form to your unique SplitForms endpoint. That's it.

We instantly capture and organize every submission in your inbox.

Send data to email, spreadsheets, CRMs, webhooks, and 7,000+ apps.

No credit card required. Set up in under 60 seconds.
Connect & automate
On paid plans, submissions can also go to Slack, Discord, Google Sheets, Notion, Airtable, Zapier or any signed webhook — and splitforms works on the platforms you build on, from WordPress and Shopify to Next.js. With Stripe connected, your forms can take payments too.

Common questions
Yes. The form is plain HTML with a single POST endpoint, so it runs on any React site without server-side code, plugins, or SDKs. Drop the snippet into a React page or component and submissions land in your splitforms dashboard.
Free for 500 submissions — no credit card, no time limit. Pro is $5/mo for 5,000 submissions a month, and Annual is $49/year for 15,000 submissions a month. The same pricing applies regardless of which framework hosts the form.
Yes. The template ships with sensible defaults (name, email, phone, company…) — add, remove, or rename any of them. Splitforms accepts whatever fields you POST.
A hidden honeypot field catches dumb bots, and a rule-based filter scores the rest; anything that looks like spam goes to a separate Spam tab instead of your inbox. No CAPTCHA, no friction for human users — and it works the same on React as on any other framework.
Yes. Webhooks are available on paid plans, with auto-formatted payloads for Slack, Discord, and WhatsApp (via CallMeBot). Or send raw signed JSON to any URL — Zapier, n8n, your own server. Configure in the splitforms dashboard.
Yes — the form posts directly to splitforms from the browser, so no server is involved. Works on Vercel, Netlify, GitHub Pages, Cloudflare Pages, S3, or any plain Apache host.
The line-of-business multi-select drives the webhook branch. Auto/home (P&C) goes to one Slack channel and AMS workflow; life goes to another (often a different licensed producer); commercial / business goes to a third. Most agencies have specialists per line — the form respects that org structure.
Not on the form itself, but the auto-responder and quote PDFs should reference your agency's E&O coverage and licensing. State insurance departments require disclosure of license numbers in marketing — add to the site footer at minimum, the form's thank-you page ideally.
Yes — webhook the JSON. AgencyZoom and EZLynx accept inbound leads via direct webhooks; Applied Epic and Vertafore (HawkSoft) accept via Zapier or their respective AMS APIs. The quote pre-loads with line, current carrier, and renewal date — saves the producer 5-10 minutes per quote.
Simple pricing
Free gives you 500 submissions for $0 — no card, no time limit. Pro is $5/month for 5,000 submissions a month, and Annual is $49/year for 15,000 a month with every Pro feature.
For side projects and indie devs.
Every paid feature, for agencies and growing products.
Every Pro feature with triple the volume — $0.27 per 1,000 at full use.
No credit card required on Free • Cancel anytime • Full pricing and FAQ