Request An Inspection - House Checkup Home Inspections

Please us this form to request an inspection. If you would like to call for an inspection please call us now at (347) 838-5066

Client Name *

First

Last

Please enter the client name

Client Email Address *

Please enter the client email address

Client Phone Number *

Please enter the clients phone number (cell phone prefered)

Client Current Address

Please enter the clients current address

Agent Name

Please enter the agent name

Agent Company Name

Please enter the agent company name

Address of Property To Be Inspected *

Please enter the address of the property to be inspected.

Zip Code of Property To Be Inspected *

Please enter the zip code of the property to be inspected

Property Type

Prefered Date and Time *

Please select your preferred date and time for the inspection. The time slot you want may not be available so make sure to also pick an alternate date and time for the inspection

Alternate Date and Time

Please select your alternate date and time for the inspection. Your preferred time slot may not be available so make sure to also pick this alternate date and time for the inspection.

Referred By

If you were referred, please enter the referrers name

Discounts you qualify for...

Please select the discounts you qualify for. Only one discount may be applied per inspection.

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