"*" indicates required fields

Please fill out this questionnaire below regarding your mold inspection service

Name*

Email*

Phone*

How did you hear about us?*

Address*

Occupancy*

Square Footage*

How many bedrooms?*

Are you working with a mold remediation contractor?*

If Yes, who are you working with?

Have you experienced a water event?*

(Plumbing leak, sump pump failure, seepage, condensation, etc.)

If Yes, please explain the type of water event and how did you address it?*

Do you have visual mold growth?*

If Yes, please explain?*

Are you or anyone else experiencing health issues suspected to be related to mold exposure?*

If Yes, please explain?*

Do you feel better when you leave and worse when you come back?*

Have you done any medical testing that indicate you are exposed to mold?*

If Yes, please explain?*

Have you done a mold test on your own?*

What were the results of your mold test?*

Is this an insurance claim?*

Anything else you would like to tell us?

Name

This field is for validation purposes and should be left unchanged.

Mold Inspection Questionnaire