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1
Are you a return customer?
IF SO, PLEASE DO NOT COMPLETE THIS FORM. CALL OR TEXT US. 626.737.7173
YES
NO
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2
Select your zip code.
*
This field is required.
Please note: If you are a return customer, you do *not* need to complete this form again.
Please Select
90041 (Eagle Rock)
90042 (Highland Park, NE LA)
90065 (Mt Washington only)
91001 (Altadena / North Pasadena)
91003 (Altadena)
91006 (Arcadia)
91007 (Arcadia)
91016 (Monrovia)
91024 (Sierra Madre)
91025 (Sierra Madre)
91030 (South Pasadena)
91101 (Pasadena, Central)
91103 (Pasadena, West)
91104 (Pasadena, Central)
91105 (Pasadena, South-West)
91106 (Pasadena, South-Central)
91107 (Pasadena, East)
91108 (San Marino & Pasadena, South)
91011 (La Canada & Pasadena border)
91020 (Glendale / Montrose)
91046 (Montrose / North Glendale)
91201 (Glendale, West
91202 (Glendale, West)
91203 (Glendale, West)
91205 (Glendale, South)
91206 (Glendale, South)
91207 (Glendale, North)91208 (Glendale, Central)
91210 (Glendale, South)
91214 (La Crescenta / North-Most Glendale)
91770 (Rosemead)
91771 (Rosemead)
91772 (Rosemead)
91776 (Rosemead)
91775 (San Gabriel)
91776 (San Gabriel)
91780 (Temple City)
91801 (Alhambra, South)
91803 (Alhambra, Central)
My zip code is not here (sorry, we do not service your area)
Please Select
Please Select
90041 (Eagle Rock)
90042 (Highland Park, NE LA)
90065 (Mt Washington only)
91001 (Altadena / North Pasadena)
91003 (Altadena)
91006 (Arcadia)
91007 (Arcadia)
91016 (Monrovia)
91024 (Sierra Madre)
91025 (Sierra Madre)
91030 (South Pasadena)
91101 (Pasadena, Central)
91103 (Pasadena, West)
91104 (Pasadena, Central)
91105 (Pasadena, South-West)
91106 (Pasadena, South-Central)
91107 (Pasadena, East)
91108 (San Marino & Pasadena, South)
91011 (La Canada & Pasadena border)
91020 (Glendale / Montrose)
91046 (Montrose / North Glendale)
91201 (Glendale, West
91202 (Glendale, West)
91203 (Glendale, West)
91205 (Glendale, South)
91206 (Glendale, South)
91207 (Glendale, North)91208 (Glendale, Central)
91210 (Glendale, South)
91214 (La Crescenta / North-Most Glendale)
91770 (Rosemead)
91771 (Rosemead)
91772 (Rosemead)
91776 (Rosemead)
91775 (San Gabriel)
91776 (San Gabriel)
91780 (Temple City)
91801 (Alhambra, South)
91803 (Alhambra, Central)
My zip code is not here (sorry, we do not service your area)
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3
Is this for a residential or commercial property?
Residential
Commercial (Sorry, we are only accepting residential customers at this time.)
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4
What are your pests?
*
This field is required.
Ants*
Beetles
Centipedes
Cockroaches*
Crickets
Earwig
Flea*
Fly / Gnat
General Pests* (interested in preventative regular service)
Millipedes
Mites
Mosquitoes
Rodents*
Spiders
Springtails
Ticks
Wasps*
Yellow Jackets*
NOT SURE* (please take clear pictures of evidence and text to: 626.737.7173. Please also describe in next step.)
Other
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5
Where are your pests active?
*
This field is required.
Living Space*
Garage
Exterior
Attic
Subarea
Other
Other
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6
First & Last Name (Must use Title Caps (e.g. John Snow).
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First Name
Last Name
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7
Your relationship to the property
*
This field is required.
Owner
Property Manager
Tenant
Other (please specify on next screen)
This is for a business property (Sorry, we are only accepting residential customers at this time).
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8
All tenants must pay a non-refundable $100 deposit for inspections they initiate and pay in advance for any jobs to which we proceed not arranged by the landlord or designated agent. Do you agree to this?
Yes, I agree.
No, we're done here.
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9
Type of property
*
This field is required.
Single Family Home
Duplex
Condo
Townhome
Triplex
Business, Standalone Structure
Business, Shared Structure
Apartment
Other
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10
Please select all that apply to your home
Ignore the parentheses.
1-story home (+0)
2-story home (+0)
3-story home (+0.5)
Craftsman Home / Wood siding (+0.5)
Spanish Tile Roof (+0.5)
Other Tile Roof
Asphalt Shingle Roof (+0)
Flat Roof (+0)
I don't know what type of roof
Multiple Balconies (+0.3)
Home is in poor condition and there are many openings (0.5)
There are features of my home that would require more than an hour to thoroughly inspect (+0.5)
Other
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11
Email (must belong to name provided above)
*
This field is required.
example@example.com
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12
Phone Number
*
This field is required.
Please enter a valid phone number.
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13
Address
*
This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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14
Unknown Pest
Please describe as accurately as possible: color, size in inches, how many you see at a time, what they are doing, and what they are attracted to or feeding on.
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15
Any other details to share?
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16
How did you find this form?
Website
Nextdoor
Google
Referral
Yelp
A Pasadena Pest rep provided it
Other
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17
How did you find us?
Yelp
Google
Nextdoor
Referral
Other
Vehicle
Physical Ad
Event
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18
Select the roach you've seen.
American
German
Oriental
Turkestan
Brown-Banded
Smoky Brown
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19
Select the ants you've seen.
Argentine (1/8", brown) Most common ant
Little Black (1/16", shiny black)
Velvety Tree (full size is 1/4", black and red)
Carpenter (1/4-1/2", black or yellow & black)
Red Imported Fire
Pharaoh (1/12-1/16", yellow to reddish brown)
Thief (1/16" mostly, yellow to bronze to dark brown)
Ghost (1/2-3/4", head/thorax: brown, gaster/legs milky white)
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20
Next steps
We'll be in touch soon to schedule. Please note that if we are very busy, we may not reach out until after hours. Thank you for your patience. We'll be with you ASAP!
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21
Rodent Services
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ORDER SUMMARY
Total cost
USD
Rodent Entry Point Inspection - 60 mins
Detailed examination of structural rodent-conducive openings, evidence of activity, and conducive conditions in the following areas: 1) Exterior perimeter 2) Roof 3) Attic 4) Walk-in basement (no crawl)
$
200.00
+
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Subarea Crawl Inspection (60 mins - add-on)
Add-on to Entry Point Inspection. Detailed inspection of subarea to identify rodent activity, open drain pipes allowing entry from sewers, pipe damage, leaks insulation drooping and damage, duct damage, and other issues.
$
150.00
+
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Living Space Inspection (30 mins - add-on)
If you have rodent activity in the living space or wish to have the living space inspected for openings preventatively, add this inspection.
$
50.00
+
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Living Space Traps (Kid/Pet Friendly) 4-count
These protected traps are enclosed in either a box station or tunnel to protect pets and children from snapping themselves. This price is for 4 traps. If you have a lot of activity, you will need more. We strongly recommend pre-baiting (baiting but not setting until exclusion) because it's more effective, but we'll set them during inspection if you like.
$
100.00
+
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(Detached) Garage Inspection - 30 mins
SFH Garages only. Pricing applied to job (for this inspection only)
$
100.00
+
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Guest House Inspection (add-on)
Same inspection as the Rodent Entry Point Inspection, except for an added Guest House / Casita.
$
100.00
+
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Rodent Birth Control Inspection - 30 mins
Ongoing service. Can be indoors and/or outdoors. Non-lethal pet- and wildlife-safe alternative to poisons. Quoted on site (price contingent on number of stations needed). Add to cart to indicate interest.
$
Free
+
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Lethal Rodent Baiting Inspection - 30 mins
This is an exterior rodent population suppression service that uses secured poisons to reduce rodent pressure on your property. The poisons we use come with reduced risk of secondary poisoning. It should only be used if your home / structure is sealed. This is an ongoing service. Quoted on site (based on station count). Select to indicate interest.
$
Free
+
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Trapping Service (Rats & Mice)
This service can be interior and/or exterior. It is NOT meant to replace an exclusion. Quoted on site. $200 min. for initial visit.
$
200.00
+
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Subarea Crawl Inspection Only - 60 mins
Detailed inspection of subarea to identify rodent, roach, and other pest activity; open drain pipes allowing entry from sewers; pipe damage; leaks insulation drooping and damage; duct damage, and other issues. (Select this crawl option when NOT adding on to another service/inspection)
$
200.00
+
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22
Please provide authorization for us to contact you.
Must do so to proceed.
I authorize Pasadena Pest Control Inc. to contact me via text, phone call and email.
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23
In order to proceed and remain on schedule, I acknowledge that I must also sign the Customer Handbook which contains Pasadena Pest Control's services, policies and disclosures. This is automatically emailed to the email I have provided upon submission of this form.
I understand and am checking my email!
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24
Select the small flies you've seen
Drain Fly
Fruit Fly
Fungus Gnat
Other
Unsure
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25
Select the flies that you've seen.
Green Bottle Fly
Blue Bottle Fly
Flesh Fly
Cluster Fly
House Fly
Other / Unsure
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26
Please identify referral.
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27
Return customers: Good to see you again! Please call or text us at (626) 737-7173.
Talk soon!
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28
We're sorry, but we only offer rodent services to Single Family Homes.
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