Contact Us / FREE Estimates

Breathe Fresh LLC, Customer Evaluation Form

Air Duct Cleaning

Square footage of house (Including Basement) ____

Year house build? _____

Does the house have central air (i.e. A/C)?     Y / N

Is there a basement? ____ Is it finished? ____  Is there a crawl space?____

Furnace Location: (Check One)


Crawl Space


Main Floor Closet

Do you want disinfectant and which one?    Y / N ____

Basic sanitizer  _____

High Grade sanitizer (Oxine)  ____

Chimney Sweep & Fireplace Inspection

How many stories? ____

Type (Check one)

Traditional Brick

Metal stove insert

Pot belly stove

Gas fireplace

Type of “Flue”?  Tile or  Metal Liner ____________

Dryer Vent Cleaning

How many Feet from dryer to outside wall ______ Vent Location? Roof or Side of House________