Air – Mold Testing Form Date:* MM slash DD slash YYYY Mold Expert:* First Last Customer:* First Last Property Address:* Street Address City State / Province / Region ZIP / Postal Code Front of Home Photo Upload: Drop files here or Select files Max. file size: 256 MB. Please list sample types: Sample Type: Sample Location: Sample #: Air Swab Tape Grounds/Exterior Basement Attic Crawlspace Garage Master Bathroom Bathroom 1 Bathroom 2 Master Bedroom Bedroom 1 Bedroom 2 Living Room Dining Room Kitchen Laundry Room Other How did Customer Pay?* Square Check Cash Online Not yet paid, please contact customer for payment Additional Technician Notes: Include this verbiage: Please use this section to provide any specific comments regarding information obtained from the client at the time of visit and also to note any recommendations made by you to client. Any and all important information obtained at time of visit should be noted here
