We Would love to hear from you   Please fill out our online form or feel free to call our offices to get the service and value you deserve. Lawrence/ Topeka Kansas City   Contact information Title             Mr. Mrs. Ms. Dr. Prof. First Name Last Name Company Name Home Phone Cell Phone Business/Day Phone E-mail address BRS email lists are not shared or sold to anyone. Please confirm that this is the correct email address. Street Address     City     State Kansas Missouri Zip Code     Preferred Contact Method Home Phone Business Phone Cell Phone Email How did you hear about BRS The Yellow Book AT&T Yellow Pages Website From a current client Newspaper Ad postcard, door hanger, mailed advertisement Personal Contact with BRS employee other If "From a Current Client" was chosen please list the client    If other please specify here:  Information will be processed only for residences within our Service Area  Schedule Service   Services Requested : Brown Recluse Treatment Termite Control Cockroaches Ant Control Home Pest Inspection Quarterly Pest Treatment Service Other Service Schedule an appointment Choose the best Day to Schedule an appointment. You will receive a call or email confirming the date and time. MON      TUE      WED      THU      FRI      SAT Early Morning (4 am to 8 am)    Midday (11 am to 3 pm)    Morning (8 am to 11 am)             Afternoon (3pm to 5 pm)      House Information Request Please take a few moments to fill out our house information form to provide details about your home and pest problem that will provided BRS with a head start to providing excellent service. Age of your home  How long have you lived at your current residence? What is the size of your house? (square feet)  Please provide house size as a simple measure of Length X Width. Do you have an ATTIC? Yes No   Is your attic Finished Unfinished  (if both, please check both and give an estimate of the percentage of each in the comments box) Do you have a basement ? Yes No   Is your basement Finished Unfinished Does your house have a crawl space? Yes No Does your home have drop ceilings (suspended panel) ? Yes No How many brown recluse do you see per day? per week? Do you have pets? Yes No  What type of pets do you own (list everything including fish)? How many people occupy your residence? Do you have young children? (Under age 13) Yes No  How old are the children? Child 1 Child 2 Child 3 Additional comments: Please type additional comments here.   ©2008 Brown Recluse Solutions Pest Control and Consulting