Electrical Safety Check Form

Electrical Safety Check Form

Please provide all necessary information to schedule and prepare for your electrical safety inspection. The inspection costs $250 and includes a detailed report. We will get in contact with you if the preferred time is not suitable.
Full Name

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

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Property Type
What is the approximate age of the electrical installation?
When was the last electrical safety inspection (if known)?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
How many bedrooms
Add photo of switchboard
Are there smoke alarms present in all bedrooms?
Preferred date for inspection

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Preferred time for inspection

Hour Minutes

AM/PM Option
Additional notes or specific concerns
Should be Empty: