Name *

First

Last

Email *

Business Name (If Applicable)

Contact Mobile Phone *

Your relationship to property *

Property Address *

Address Line 1

Address Line 2

City

State / Province / Region

Part of a Body Corporate (or other partial ownership scenario)

Yes
No
Unsure

Approx Floor Area (m2) *

Bedrooms *

Approx Build Date (Decade is acceptable) *

Occupancy Status *

How did you hear about us ?

Preferred Service Date - When would you like your assessment completed ? *

Comments & Any H&S issues to disclose ?

As the property owner (or duly authorised agent) - I authorise All Clear Group Limited to attend my property address (as supplied) to undertake a Healthy Homes Assessment and charged accordingly (as per allclear.nz/hh) *

Agreed

Phone

Client Disclosure : The client is required to inform the assessor of any existing issues that they are aware of that have been an issue in the past or may become an issue in the future or at the time of the assessment.

Please note our Terms of Service Applies to this (and all other services) full details are here

Full details of our Market Leading Healthy Homes Compliance Service are here