Consumer Questionnaire

1. Consumer Questionnaire
2. What type of Guarantee (if any) do you have? Repair and Retreat Guarantee Retreat Only Guarantee None
3. Do you have a copy of your original contract with your pest control company?
4. Yes No
5. Date of initial treatment:
6. Date damage was discovered :
7. What do you feel your pest control company should do and why?
8. What do you believe your pest control company has done improperly?
9. Are you currently in litigation?
10. Yes No
11. Additional Comments:
12. Name(required)
13. Address(required)
14. City, State
15. Zip Code
16. Day Time Phone Number(required)
17. Night Time Phone Number
18. E-mail(valid email required)