Client Questionnaire Please complete as much as you can of the form below. Note, some fields are required.Name(Required) First Last Email(Required) Phone(Required)Actual Exact Address of Inspection Location including Street Number (NOT Sales Office, NOT Model Home, NOT Closest Street, NOT your Current Home). Don’t worry, we will find it, but if you want to include the closest mappable street address please only include that in the Notes section below, NOT here!(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Lot Number (If New House)Sub Division / Neighborhood NameWhen do you need your inspection?(Required) On this date below ASAP Undetermined Date you need the inspection(Required) MM slash DD slash YYYY Preferred Time of Day(Required) Morning Afternoon This field is hidden when viewing the formIf date of inspection is undetermined, please check the box below Undertermined Date you need the inspection report completed by MM slash DD slash YYYY Date of your walk-thru / orientation / due diligence end? MM slash DD slash YYYY Type of Inspection(Required)Select OnePre-Drywall Inspection (New Home)New Home Final InspectionStandard Inspection for Resale HomeStandard Inspection for Pre-ListingStandard Inspection for MaintenanceStandard Inspection for 11th Month WarrantyFinished Square Footage (Including Finished Basement)(Required)Year Built(Required)Foundation Type(Required)Select OneUnfinished BasementFinished BasementSlab-on-GradeCrawl-SpaceBasement/Crawl-Space ComboSplit Level - Slab on GradeSplit Level - Slab/Crawlspace CombNumber of Bedrooms(Required)Select number of bedrooms12345678910Number of Bathrooms(Required)Select number of bathrooms11.522.533.544.555.56Your Agent's (Realtor) Name First Last Your Agent's (Realtor) Email Your Agent's (Realtor) Phone NumberBuilder Company Name (For New Home Only)Construction Manager Name (For New Home Only) First Last Construction Manager Phone Number (For New Home Only)Listing Agent Realtor (Resale Home) / Builder Agent Realtor or Office Manager (New Home) - to Notify About InspectionFMLS number (If Listed)Will you be attending the inspection?(Required)Select OneYes, entireYes, at the endNoUndecidedOccupied or Vacant? (If New Home, then Vacant)(Required) Occupied Vacant Please check any Extra Services that you need (Extra Fees apply - see Pricing Tab in menu above) Re-Inspection (after correction/repairs are made) Radon Test (typically only needed with basement) Termite Inspection (not needed for new homes) Mold Sample Test (not needed for new homes) Pool / Spa Inspection Septic Load Evaluation (not needed for new homes) Detailed Thermography Inspection (basic scan is included already) Water Quality Test (typically not needed for municipal water) Lead Paint Test (only needed if house is older than 1978) Repair Pricer Estimate (3rd party cost estimate sent 24hr after inspection report completes) 2nd Kitchen Detached Garage Access Codes / NotesAdditional Info / Comments Δ
