Serving the Midwest & Many Southern States
Open 24/7
1-800-759-6960  
help@extremeremediation.com
Serving the Midwest & Many Southern States
Open 24/7
1-800-759-6960  
GET A FREE ESTIMATE

Service Information

At this time, you’ve been in communication with a representative of Bio-Trauma 911, dba Extreme Remediation, and you’ve been asked to complete this form. Upon receipt of this completed form our office will either send you a formal cost estimate or, if that has already been done, a written service agreement.
Homeowner, Renter, Resident Name
If the homeowner, renter, or resident is deceased and you are the executor or administrator of the estate, please put your information in this block and complete the applicable sections below
Address (where service to be provided)
I am the financially responsible party for this job/project

Financially Responsible Party (FRP) Details

FRP Name (if different from above)
Sometimes, a family member or friend will be the financially responsible party. If this is the case, please complete this section. If you are the POA or executor of the estate, please complete this section.
FRP Mailing Address

POA or Executor of Estate

Are you the executor or administrator of the estate?
Are you the POA for the above homeowner, renter, or resident?
I am the homeowner, renter, or resident and no one else is involved in this project
I or another individual would like to be present to oversee the cleaning project
Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Additional Information

Are there documents in the home that need to be shredded or professionally destroyed?
If the home is an apartment or condo, and a dumpster is required, you will need to seek authorization from the HOA or management company to allow us to place a dumpster
If we are unable to place a dumpster, we can use a trailer to transport items to the city dump or landfill. Dumpsters are typically set at the jobsite one day prior to the start of service. If service starts on a Monday, dumpsters may be delivered on the preceding Friday.
I am not good with computers and may have difficulty with (choose all that apply)
If needed, we will do everything we can to help you with the tasks outlined above
Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Our Process

Thank you again for your interest in working with Bio-Trauma 911 and Extreme Remediation

Here's a step by step guide to hiring us for your remediation or cleaning needs:

  • Complete and submit this form
  • Confirm through a phone call or email the details of the project
  • Receive and digitally sign a cost estimate
  • Agree to a service start date
  • Receive and digitally sign a service agreement
  • Receive an invoice for the down payment and submit an online payment. We require a 50% deposit one week prior to the service start date. Please see below for more information on payments
  • If a dumpster is required, ensure the area is clear for dumpster placement. Dumpsters are typically dropped off the day before the service start date
  • If you are not going to meet the team at the house, leave a key hidden on property and provide us with the location of the key or provide an alternate means to access the residence

You do not need to be present during the cleaning process. We should have a full and complete understanding of your needs and expectations and can complete the job in your absence.

Many company require full payment in advance. Although you may pay the full cost up front, we split the balance into two payments. The first payment of 50% of the quoted cost is due one week prior to the service start date. The final payment is due before the project is completed. If you would like an explanation for this payment structure/plan, please ask.

Should you have any questions about our service history, please note our perfect Google reviews & BBB rating. Any questions about this form or our services can be directed to Brandon Stone at (317) 759-1912 or at bstone@biotrauma911.com