Basement Waterproofing
& Foundation Repair

1-888-744-4925

Basement Technologies®
Home Assessment Form:

Get your free home estimate for: basement waterproofing, foundation repairs, crack injections, and drain repairs. All information collected here will be held with strict confidentiality. Please read our privacy policy for details.

PERSONAL INFO
Your Contact Info:

ALL fields marked with (*) ARE required.

Prefix:
First Name:
Last Name:
Email:
Home Phone:
Cell Phone:
Best Contact Time?

Company:
Work Phone & Ext.:
Fax Number:

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RESIDENTIAL PROPERTY (#1):
(Project Information)

Please fill out the below form-fields as best as you can. The better the details, the easier it will be later on to cater a home assessment for your unique project needs.

ALL fields marked with (*) ARE required.

Property Info:

Ownership Info:***
Foundation Type:*
Finished Basement?
Year Constructed?

Full Address:*
Suite #:*
City:*
Postal Code:*
Cross Street(s):
Tenants Name:
Tenants Phone:

*
*

*
*
*
*

Service(s) Needed:

Project Information:

Misc Details:

• Has a permit been issued?
• Architectural drawings already created?

• Have you been pre-approved for gov. subsidy?
» If so, which one?

RESIDENTIAL PROPERTY (#2):
(Project Information)

Please let us know about any other property that require our services.

ALL fields marked with (*) ARE required.

Property Info:

Ownership Info:***
Foundation Type:*
Finished Basement?
Year Constructed?

Full Address:*
Suite #:*
City:*
Postal Code:*
Cross Street(s):
Tenants Name:
Tenants Phone:

*
*

*
*
*
*

Service(s) Needed:

Project Information:

Misc Details:

• Has a permit been issued?
• Architectural drawings already created?

• Have you been pre-approved for gov. subsidy?
» If so, which one?

RESIDENTIAL PROPERTY (#3):
(Project Information)

Please let us know about any other property that require our services.

ALL fields marked with (*) ARE required.

Property Info:

Ownership Info:***
Foundation Type:*
Finished Basement?
Year Constructed?

Full Address:*
Suite #:*
City:*
Postal Code:*
Cross Street(s):
Tenants Name:
Tenants Phone:

*
*

*
*
*
*

Service(s) Needed:

Project Information:

Misc Details:

• Has a permit been issued?
• architectural drawings already created?

• Have you been pre-approved for gov. subsidy?
» If so, which one?

How Did You Hear About Us?*

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HOME ASSESSMENTS:

OFFICE HOURS:

MONDAY: 8:00am - 5:00pm
TUESDAY: 8:00am - 5:00pm
WEDNESDAY: 8:00am - 5:00pm
THURSDAY: 8:00am - 5:00pm
FRIDAY: 8:00am - 5:00pm
SAT - SUN: CLOSED