Also, doesn't the visual style look a little too much like Uber?
Get started CTA is lost and the input fields are so low contrast you can barely tell they exist.
I can't discern the difference between plain text and a link in the footer. Also, it's not really responsive :(
Also, no form validation. Sent a request with everything empty except phone number which i put as "5". Hope you don't get flooded with invalid requests!