Occupied Form (English)
  • Occupied Form (English)

  • Installation Date*
     - -
  • Installation Type*
  • Pet*
  • COVID - 19 Screening Questions

  • Have you or anyone at your residence had contact with anyone known to have been diagnosed with COVID-19?*
  • Have you or anyone at your residence has a POSITIVE COVID-19 test for ACTIVE virus in the past 10 days?*
  • Have you or anyone at your residence have any of these symptoms that you cannot attribute to another condition? (Fever or chills, Cough, Shortness of Breath or difficulty breathing, Fatigue, Muscle or body ache, Headache, Recent onset of loss of taste or smell, Sore throat, Congestion, Nausea or vomiting)*
  • Unit Inventory

    Select the box next to all items in your unit
  • Living Room
  • Dinning Room
  • Bedroom #1
  • Bedroom #2
  • Bedroom #3
  • Kitchen/Laundry - Impact Property Solutions does not move Stackable Washer/Dryers
  • All Breakable Items must be moved by the resident prior to install, the

    refrigerator must be empty of any liquids.

     

  •  
  • Should be Empty: