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Installation Survey Form
To complete the installation survey form, you will need to have the following information:

1. Name, address and contact phone number
2. Best time for an in-home evaluation
3. Provide existing tub length,width, & height
4. Bathroom Door opening size
5. Wall-to-wall dimensions of bathroom

Please fill out the form as completely as possible. Measurements should be recorded in inches.

First Name:*
Last Name:*
Phone Number:*
Mobile Number:
Best time for in-home evaluation:*
Existing Tub Length:
Existing Tub Width:
Existing Tub Height:
Bathroom Door Width:
Bathroom Door Height:
Wall-to-Wall Bathroom Measurements:
* - Required Field.

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