Online Survey Form

Online Survey Form - Kearney Moving

Name *

First

Last

* Indicates required field

Email *

Instructions
Getting a good estimate requires accurate information. Whenever possible we prefer to make a personal visit to your address to visually document all the items to be moved. While an in home visit provides us the greatest accuracy, it may not always be practical. In such cases we can have you complete an online survey. Please take a moment and fill out the general information and attach pictures to the areas that reflect your residence. When supplying us with pictures please provide 4-5 good pictures per room that will represent a 360 degree view of that area.

General Information

Type of residence *

Number of bedrooms *

Levels at the house *

Apartment Floor *

Kitchen

Kitchen Picture #1 *

Max file size: 20MB

Kitchen Picture #2 *

Max file size: 20MB

Kitchen Picture #3 *

Max file size: 20MB

Kitchen Picture #4 *

Max file size: 20MB

Kitchen Picture #5 *

Max file size: 20MB

Dining Room

Dining Room Picture #1 *

Max file size: 20MB

Dining Room Picture #2 *

Max file size: 20MB

Master Bedroom Picture #3 *

Max file size: 20MB

Master Bedroom Picture #4 *

Max file size: 20MB

Master Bedroom Picture #5 *

Max file size: 20MB

Master Bedroom

Master Bedroom Picture #1 *

Max file size: 20MB

Master Bedroom Picture #2 *

Max file size: 20MB

Master Bedroom Picture #3 *

Max file size: 20MB

Master Bedroom Picture #4 *

Max file size: 20MB

Master Bedroom Picture #5 *

Max file size: 20MB

Bedroom #1

Bedroom 1 Picture #1 *

Max file size: 20MB

Bedroom 1 Picture #2 *

Max file size: 20MB

Bedroom 1 Picture #3 *

Max file size: 20MB

Bedroom 1 Picture #4 *

Max file size: 20MB

Bedroom 1 Picture #5 *

Max file size: 20MB

Bedroom #2

Bedroom 2 Picture #1 *

Max file size: 20MB

Bedroom 2 Picture #2 *

Max file size: 20MB

Bedroom 2 Picture #3 *

Max file size: 20MB

Bedroom 2 Picture #4 *

Max file size: 20MB

Bedroom 2 Picture #5 *

Max file size: 20MB

Bedroom #3

Bedroom 3 Picture #1 *

Max file size: 20MB

Bedroom 3 Picture #2 *

Max file size: 20MB

Bedroom 3 Picture #3 *

Max file size: 20MB

Bedroom 3 Picture #4 *

Max file size: 20MB

Bedroom 3 Picture #5 *

Max file size: 20MB

Office/Craft Room

Office/Craft Room Picture #1 *

Max file size: 20MB

Office/Craft Room Picture #2 *

Max file size: 20MB

Office/Craft Room Picture #3 *

Max file size: 20MB

Office/Craft Room Picture #4 *

Max file size: 20MB

Office/Craft Room Picture #5 *

Max file size: 20MB

Storage Room

Storage Room Picture #1 *

Max file size: 20MB

Storage Room Picture #2 *

Max file size: 20MB

Storage Room Picture #3 *

Max file size: 20MB

Storage Room Picture #4 *

Max file size: 20MB

Storage Room Picture #5 *

Max file size: 20MB

Garage

Garage Picture #1 *

Max file size: 20MB

Garage Picture #2 *

Max file size: 20MB

Garage Picture #3 *

Max file size: 20MB

Garage Picture #4 *

Max file size: 20MB

Garage Picture #5 *

Max file size: 20MB

Outdoor Items

Outdoor Items Picture #1 *

Max file size: 20MB

Outdoor Items Picture #2 *

Max file size: 20MB

Outdoor Items Picture #3 *

Max file size: 20MB

Outdoor Items Picture #4 *

Max file size: 20MB

Outdoor Items Picture #5 *

Max file size: 20MB

Storage Shed

Storage Shed Picture #1 *

Max file size: 20MB

Storage Shed Picture #2 *

Max file size: 20MB

Storage Shed Picture #3 *

Max file size: 20MB

Storage Shed Picture #4 *

Max file size: 20MB

Storage Shed Picture #5 *

Max file size: 20MB

Utility Room

Utility Room Picture #1 *

Max file size: 20MB

Utility Room Picture #2 *

Max file size: 20MB

Utility Room Picture #3 *

Max file size: 20MB

Utility Room Picture #4 *

Max file size: 20MB

Additional Pictures

Additional Picture #1 *

Max file size: 20MB

Additional Picture #2 *

Max file size: 20MB

Additional Picture #3 *

Max file size: 20MB

Additional Picture #4 *

Max file size: 20MB

Additional Picture #5 *

Max file size: 20MB

Please leave any comments regarding special circumstances including: items that don't go, fragile items of concern, high value items, etc. *

Submit