Customer Satisfaction Form

Customer Satisfaction Form

Please provide the following information for data collection purposes.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Service

MonthDayYear
Date
Service Type
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does your concern fall within the standards of practice as defined by the International Association of Certified Home Inspectors or the Illinois Emergency Management Agency (IEMA)?
Service Performed
Possession Date (if applicable)

MonthDayYear
Date
Closing Date (if applicable)

MonthDayYear
Date
Date of Walkthrough Prior to Closing (if applicable)

MonthDayYear
Date
Was the issue present at the time of completed service or final walk through?
Was the concern in the seller's disclosure? (if applicable)
Upload a copy of the seller's disclosure.

Cancelof
What is the concern you are experiencing?
What type of radon mitigation system issue are you experiencing? (most common issues are listed below)
Detailed account of what I am experiencing. Please add any relevant images below.
Crawlspace encapsulation concerns
Detailed account of what I am experiencing. Please add any relevant images below
I hereby certify that all statements and information provided in this form are true and complete to the best of my knowledge. I understand that any false or misleading information may void warranties or service agreements
Your concern is important to us. Please allow one business day for our team to review your request and contact you with a solution to your concern.
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