Treatment Request Form


Please fill out the form and click the send button at the bottom of this page when you are finished.

Choose One:
 
First Name: 
Last Name: 
Street Number 
Street Name: 
City: 
Zip Code: 
Home Phone: 
Work Phone: 
Cell Phone: 
E-mail: 
  • Lawns under 3000 sq.ft. are $43.38 Plus Tax.

  • Lawns 3000 to 5000 sq.ft. are $48.95 Plus Tax.

  • Lawns over 5000 sq.ft. will not receive the first treatment until we have talked to you.


Will you need to be at home at the time of the treatment?    
Are there any gates that need to be unlocked?   
Are there any pets that need to be put up?   
Do you have a pool?   
Has the lawn been seeded or sodded in less than 1 year?   

If yes, when was it seeded or sodded?

  MM / YYYY
Would you like a quote for the Tree and Shrub program at the time of the treatment.
   (Prices are based on amount and size of plantings)
  
What is the approximate size of your lawn? (in sq. ft.) 
   (Lawn Tech reserves the right to verify measurement and adjust pricing to the correct square footage.)
How did you first hear about us? 
If we were referred, who referred us?
Name: 
Address: 
Would you like us to call before coming out for the first treatment?
 or come out as soon as possible? 
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Feel free to add any other comments, questions,
 special instructions or directions etc.