AC LEAK / DRAIN LINE BACKUP CHECKLIST
Section 1 – Basic Contact Info
REQUIRED
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
State
*
Back
Next
Section 2
1. What caused the issue?
*
Clogged AC drain line
Drain pan leak
Condensate pump failure
Frozen coil thaw
Not sure
2. When did you first notice water?
*
Within 48 hours
Within the past week
More than a week ago
Not sure
3. Has a claim already been filed?
*
Yes
No
Not sure
4. Have you noticed any of the following?
Swollen basseboards
Warped flooring
Ceiling stains
Musty smell
visible microbial growth
None
Not sure
Submit
Should be Empty: