Bed Bed Inspection Form

Bed Bed Inspection Form

One of our experienced technicians will complete a thorough inspection of your home to examine areas of suspected bed bug activity. If bed bug activity is found we will create a treatment plan that fits your individual needs.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number of Bed Rooms in the home
Areas of Concern

Bedroom ( Beds, Clothing)Living Room (couch, chairs, carpet, flooring)Bedroom & Living RoomOther
Have you or anyone in your home experienced any bit marks or itching?
Have you or anyone in your home traveled in the last 30 day? (Bedbugs are hitch hikers, they hitch a ride in your luggage, purses, backpacks, or other items placed on soft or upholstered surfaces. They can also travel between rooms such as apartments and hotels)
Have you recently purchased/received new or used furniture?
Please attach any photos you have taken (This is not required, but if you have taken any photos please attach them here, thankyou)

Cancelof
Anything else we need to know?

The cost for your professional Bed Bug Inspection is $50.00 (non-refundable). If bed bug activity is found we will create a treatment plan that fits your individual needs. The $50 will then go towards the cost of your treatment plan.

Acknowledgement
I hereby acknowledge that I have provided full and accurate information. I understand that the $50 inspection fee is non refundable.
Signature

Inspection*

Residential Bed Bug Inspection

$50.00 Quantity

Total

$0.00

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