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1
Full Name
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First Name
Last Name
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2
Phone Number
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Please enter a valid phone number.
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3
Email Address
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example@example.com
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4
Suburb / Town
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5
Full Property Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
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Cote d'Ivoire
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Laos
Latvia
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Lesotho
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Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
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Micronesia
Moldova
Monaco
Mongolia
Montenegro
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Nicaragua
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Norfolk Island
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Northern Mariana
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Oman
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Palau
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Panama
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Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
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South Ossetia
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Sri Lanka
Sudan
Suriname
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eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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6
Preferred Contact Method
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Phone
Email
SMS
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7
Best Time to Contact
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Morning
Midday
Afternoon
After 5pm
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8
Your Role
*
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Owner Occupier
Tenant
Landlord
Property Manager
Strata Representative
Business Owner
School Representative
Other
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9
Property type
*
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House
Apartment/Unit
Townhouse
Office
Retail
Industrial
School/Childcare
Medical
Other
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10
Areas of concern
*
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Bedroom
Living area
Bathroom
Kitchen
Laundry
Roof cavity
Subfloor
Hallway
Office
Classroom
Storage room
Entire property
HVAC
Other
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11
Number of rooms/areas affected
*
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1
2
3
4
5+
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12
When was the issue first noticed?
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Within the last week
Within the last month
1–3 months ago
More than 3 months ago
Unsure
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13
Was there a known water event?
*
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Yes
No
Unsure
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14
Source of water event
Roof leak
Plumbing leak
Flooding
Stormwater ingress
Condensation
Shower or bathroom leak
Rising damp
HVAC leak
Sewage
Unsure
Other
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15
Current signs present
*
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Visible mould
Musty odour
Dampness
Condensation
Staining
Bubbling paint
Peeling finishes
Dust build-up
Fibre concerns
Poor ventilation
Occupant symptoms
None
Other
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16
Are air conditioning or ventilation systems involved?
*
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Yes
No
Unsure
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17
Type of air conditioning or ventilation system
Split system
Ducted system
Exhaust ventilation
Mechanical fresh air
Ceiling cassette
Unsure
Other
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18
Is anyone experiencing symptoms that may be linked to indoor air quality?
*
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Yes
No
Unsure
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19
What symptoms are being experienced?
Sneezing
Coughing
Asthma irritation
Sinus issues
Headaches
Skin irritation
Eye irritation
Fatigue
Other
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20
Who is affected?
Adults
Children
Elderly occupants
Staff
Customers
Students
Sensitive or immunocompromised persons
Pets
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21
How urgent is the assessment?
*
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Urgent and want this looked at as soon as possible
Important within the next few days
Planning and gathering information
Just exploring for now
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22
What outcome(s) would you like from the assessment?
Find out whether mould is present
Understand if the property is safe
Determine moisture issues
Identify source causes
Get professional sampling
Prepare for remediation
Clearance or post-remediation assessment
Obtain documentation
General peace of mind
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23
Have any prior inspections, testing, or remediation already been done?
*
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Yes
No
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24
Please provide details of any prior inspections, testing, or remediation.
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25
Is written reporting or documentation needed?
*
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Yes
No
Maybe
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26
What is your current stage?
*
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Ready to book an assessment
Need pricing first
Need advice on next steps
Comparing providers
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27
Do you have any photos or documents to upload?
*
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Yes
No
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28
Upload photos or documents
Drag and drop files here
Select files to upload
Max. file size
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29
Preferred appointment timing
*
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ASAP
Next 2 days
This week
Next week
Flexible
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30
How did you hear about us?
*
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Google search
Instagram
Facebook
Referral
Real estate/property manager
Builder
Existing client
Other
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Google search
Instagram
Facebook
Referral
Real estate/property manager
Builder
Existing client
Other
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31
Additional notes
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32
Consent to be contacted
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I consent to being contacted in relation to this enquiry and understand that submission of this form does not confirm a booking until confirmed by the team.
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