New Client Profile Form

Please fill out this form in its entirety for each structure you wish to be considered for consultation.

Contact Information

Property and Structure Information

Check the Applicable Description for Each of the Following Categories

  • Single Family
  • 2-4 Family
  • Other Residential
  • Non-Residential
  • Basement
  • Slab On Grade
  • Crawlspace
  • Pile
  • Pier, Post or Column
  • Parallel Shear Walls
  • Wood
  • Masonry
  • Concrete
  • Manufactured Housing
  • Steel
  • Primary Residence
  • Non-Primary Residence
  • Rental
  • Business
  • Non-Residential
  • Other

Flood Insurance Information

Yes No
Yes No
Yes No

Please complete if your building is elevated on crawlspace, solid foundation walls, piers, post, piles or columns and/or has an attached garage. The statement must be signed by the insured/client.

Overall Structural Questions

  • Piles, posts or piers
  • Columns
  • Parallel shear walls
  • Solid perimeter walls
Yes No
Yes No

Enclosure or Crawlspace


Yes No

Vents & Openings

  • Insect screening/lattice
  • Certified breakaway walls
  • Solid wood frame walls
  • Concrete block/brick/masonry walls
  • Other
Enclosure Details Yes No

Attached Garage


Vents & Openings

Attached Garage Details Yes No