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ClearTap System Design & Install Intake Form

Please fill out the form below:

Name*

Address*

Email*

Phone*

How many people live at your residence?

How many bathrooms do you have?

How many bathtubs do you have and are any jacuzzi tubs?

How many showers do you have and are any walk-in, body spray showers?

How many toilets do you have?

How many bathroom sinks and how many kitchen sinks do you have?

How many outdoor spigots do you have?

Do you have lawn irrigation?

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