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Name
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Address
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Residential
Commercial
Age of Roof
5-10 Yrs
10-15 Yrs
15-20 Yrs
20-25 Yrs
25+ Yrs
Condition
New
Good
Fair
Poor
Approx Sq. Footage
Are you an Owner?
Yes
No
What Problems are you having with your roof?
Existing Roof Material
Comp / Cedar Shake
Metal
Tile
Torch Down/Flat
Don't Know
Pitch of Roof
Flat
Med
Walkable
Steep
Materials Considering for New Roof:
Comp
Cedar Shakes
Metal
Tile
Slate
Single-Ply Membrane
Recycled Rubberized Tile/Shake
Green Roof
If you were referred to Element let us know who:
Other Comments
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