HomeCleanse Air Lightbox

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Are you currently a homeowner or a renter?

Homeowner

Renter

Do you have an HVAC system?

Which HVAC system do you have? (check all that apply)

Central HVAC

Window A/C units

PTAC units

Baseboard Heating systems

Radiant Heating System

Radiators

Steam Pipe Heating Systems

Mini-Splits

Geothermal systems

Have you had your home inspected for mold, either by yourself or a licensed indoor environmental professional?

Yes

Please note, a proper mold inspection will include lab results as well as a scope of work from the company performing the inspection. If you do not have this, choose no.

Do you have any mechanical ventilation systems? (Example: ERV system)

Yes

Do you have any whole house dehumidification systems?

Yes

Do you have a spray foamed home?

Yes

Not Sure

Did you hire a licensed indoor environmental professional or perform the inspection yourself?

Hired a licensed indoor environmental professional

Did it myself

Please note, a proper mold inspection will include lab results as well as a scope of work from the company performing the inspection.

What test did you perform?

ERMI

Air Sample

The Dust Test

Petri Dish

Other

Which company performed the mold inspection?

We Inspect

The Mold Guy

Certified Mold Assessments (Florida)

Other

Please note, if you are unsure of the company who performed your inspection, please select Other.

What company performed the inspection?

Did your inspector provide you with a detailed report that includes a recommended scope of work?

Yes

How many square feet is your residence?

0-1,000 sq. ft.

1,000-2,000 sq. ft.

2,000-5,000 sq. ft.

Over 5,000 sq. ft.

Is this home your “forever home”?

Without a doubt, we love our home!

Depends on the cost to fix it properly.

No, we plan to move in the next few years.

How important is a healthy home to you and your family?

Our entire family sees how important this is to our wellbeing and we are ready for options.

We are unsure how necessary this process is and want to learn more.

I have done my homework but one or more of my family members does not believe air quality plays an important role in our families health.

Are you or any household members currently working with a Doctor or medical practitioner to treat any chronic illness?

Yes

Who is the Doctor / Medical Practitioner?

Is there any other information about you, your family, or your home that can help me, help you?

Last step. Please enter your contact information and a member of my team will be in touch with you shortly.

Name

First Last

Phone

Street Address City State ZIP Code

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LET'S CLEANSE YOUR AIR TOGETHER

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