Contact Us or Request A Quote:
or email us at moldspecialist1@aol.com

FOR CLIENT USE ONLY
1) Full Name of Client:
2) Address:
3) City:
4) State:
5) Zip:
6) Phone Number:
7) Email Address:
8) Are you the owner, landlord, management or the tenant of the property?
9) Type of Property in Need of Mold Inspection/Remediation (House, Apt, Office, School, etc.)
10) Was there ever a flood or water damage in the property?
11) If yes, How long ago?
12) Roughly, how old is the property?
13) How many floors does the property have? (excluding basement)
14) Is there any visual mold on the walls/floors/ceiling?
15) Is there a smell throughout the property?
16) If yes, on a scale of 1-10 how severe is the smell?
17) What type of smell is it?
19) Why do you feel that you have a mold problem?
20) Allergies symptoms described by client:
21) Which member of household is experiencing these symptoms:
22) How many members reside in the household:
23) Was a physician contacted about these symptoms
24) Is anyone in the household pregnant?
25) Did you file an insurance claim:
If Yes, Who was the adjuster?
26) In what room and on which floor do you suspect mold growth?
27) Where did you hear about us?
Additional Comments:
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Have your home or business checked for mold before a problem arises  
 
Skin Rash From Mold
Respiratory Illness
Mold In Basements
Behind your walls
 
 
 
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Brooklyn (718) 677-MOLD (6653)

Manhattan (212) 534-MOLD (6653)

Long Island (516) 627-MOLD (6653)
 
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