Home Inspection Request Form

Who is filling out this request form?

---I am the buyerI am the buyer's REALTORI am the buyer's AttorneyI am the sellerI am the listing REALTORI am a friend of the client

Please provide your email:
(required for form, will not be sold or used for other purposes)

Who is purchasing the inspection? (first and last name)

First Name:

Last Name:

How can we contact the purchaser of our services? (please include the area code)

Phone: Cell Home  Work 

Email:

What is the address of the home to be inspected? (required)

Address:

City: State:

Please provide general directions or major nearby intersections.

What is the approximate square footage of home?

Approximately how old is the home?

Does the home have a slab or a pier and beam foundation?

Home has a slab foundationHome is on pier and beamHome has part slab part pier and beamUnkown

Is the home vacant or occupied?

Occupied by SellerOccupied by RentersVacant with Utilities OnVacant with Some or No Utilities OnVacant but Unsure of Utilities

Who is your Realtor?

Name:

How can I contact your Realtor if it becomes necessary for any reason?

Phone Number:

Email:

Do you have any specific concerns about the home?

Optional Inspections Available

Do you need at Termite Inspection? Yes No  (availability varies between companies)

Optional system that are present on the property include:

Sprinkler System Pool Spa Wood Deck Out Building Water Well Septic System 

Please inspect the following optional systems.

Sprinkler System Pool Spa Wood Deck Out Building Water Well Septic System 

Scheduling Information

How soon do you need to have the home inspected?

ASAPNext 3 daysNext 5 daysNext 7 daysNext 10 daysNext 14 daysContract not signed, unsure of scheduling

Additional Information

Do you have additional comments, questions or concerns?

How did you hear about this web site?

---RealtorInternetFriend / FamilyWord of MouthForumBusiness DirectoryOther

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