Form A: Please fill out this Form A for a price quote or to ask a question.                   Form B: Use Form B below to schedule a home inspection with our company.

FORM A

Get A Price Quote  Ask A Question

Buyer Name 

E-Mail Address  

Daytime Telephone  

Other Phone or Fax Number  

1. How did you hear about our company?   Yellow Pages Brochure Business Card Agent Referral Friend Referral Other Website Company Website ASHI Website Newspaper Advertisement Other   

 * If referred, please let us know who to thank! 

 *If through an ad, where did you find it? 

2. What type of home is to be inspected?   Residential Multi Family Condominium Mobile Home Apartment Building Commercial Building

3. What is the age of the home?  

4. What is the square footage?  

5. How many bedrooms?   One Two Three Four Five Six More Than Six

6. How many bathrooms?   1 1.5 2 2.5 3 3.5 4+

7. What city in Ohio is the home in?  

8. What county is the home in?  Summit County Stark County Portage County Medina County Cuyahoga County Wayne County

Comments/Ask A Question

Request An Inspection   Give Property Information Only

How would you like to be contacted?   Telephone E-Mail Fax

How did you locate our company?   Yellow Pages Real Estate Agent Friend Referral Company Website ASHI Website Repeat Client Newspaper Ad Mailer

*If referred, please let us know who to thank! 

*If through an ad, where did you find it? 

BUYER INFORMATION

Your Name  

Your E-Mail Address 

Your Current Address 

City, State, Zip Code

Daytime Telephone  

Cell Phone/Other Phone  

PROPERTY INFORMATION (About The Property To Be Inspected)

Property Address  

City, Zip Code  

County  

Main Cross Street  

Type Of Property   Residential Condominium Multi Family Investment Property Apartment Building Commercial Building New Construction

Age Of Property  

Square Footage  

Number Of Bedrooms   1 2 3 4 5 6+

Number Of Bathrooms   1 1.5 2 2.5 3 3.5 4+

Garage   None 1 car 2 car 2 1/2 car 3 car 3+ car Carport   Attached  Detached

Property Is Currently   Occupied Vacant Partially Vacant

Utilities Are Currently   On Off Unknown

Which Utilities Are Not On? Gas  Electric  Water All Utilities Are On

Furnace   FA Gas Heat Pump Electric Fuel Oil Boiler Other

Decks  Front Back Side Wrap-Around Multi-Leveled   

Other Buildings  

REALTOR INFORMATION (if applicable)

Realty Company  

Location Or Address  

Agent Name  

Agent Telephone  

Agent E-Mail  

FOR SALE BY OWNER (FSBO) INFORMATION (if applicable)

Property Owner Name  

Owner Telephone  

APPOINTMENT PREFERENCES

Please indicate the day(s) that might  be convenient  for your inspection.

Any Day  

Monday   Tuesday   Wednesday   Thursday   Friday  

Saturday   Sunday (limited)

Please indicate the time(s) that might be convenient for your inspection.

Any Time   10:00AM  2:00PM  5:00PM  Other

ANY QUESTIONS OR COMMENTS?