Survey Request Form

Surname

Title and Initials

Address for correspondence

Work Phone Number

Home Phone Number

Fax

E-mail

Address of property to be inspected if different from above

Access arrangements:

Is the property owned by you?
Yes No

Is the property occupied by you?
Yes No

If no, whom should we contact to make an appointment to carry out the survey?

If empty, can a key be obtained, e.g. from an estate agent?

Type of survey required:
Timber inspection
Associated repairs (if necessary)
Rising dampness
Associated replastering (if necessary)
Wall tie replacement

Details and areas of suspected problems:

Any other work to be estimated for:

Do you have any questions or queries?