Appointment Request

Online Appointment Request Form

Please provide a daytime phone number at which we can reach you between 9.00 and 5.00. We will confirm your appointment by phone only, within the next 3 business days. If you have not heard from us, please call our office.

First Name:

Last Name:

Email:

Phone w/ Area Code:

Street Address:

City:

Postal Code:

How old is your home?:Less than 5 years5 - 10 years11 - 20 years21 - 30 years31 - 40 years41 years or more

What type of home?:DetachedSemi-DetachedDuplexTriplexMobile HomeRow HouseOther

If other please specify:

How many storeys is your home?:1 Story2 Story3 StoryUpper Floor 1/2 Story4 Level Backsplit/SidesplitOther

If other please specify:

Do you have a wood burning appliance in your home?
 No Yes

Can we access your attic?

 No Yes

House square footage:

Additional Details:

How did you hear about CanSpec?