MOLD LIMITATION 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 moisture issue?
*
Plumbing leak
AC drain line
Roof leak
Flooding
Not sure
Other
2. When was water first discovered?
*
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?
Musty smell
Visible mold/microbial growth
Air quality concerns
Staining discoloration
Not sure
Submit
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