High-Rise Building Intake Form

Building Name*

Building Address*

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Year of Construction*

Number of Floors*

Primary Use of Building*

Total Number of Units (Apartments/Offices)*

Owner or Management Company Name*

Contact Person Name*

First NameLast Name

Contact Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Contact Email Address*

example@example.com

Amenities Available

Safety Features Present

Upload Building Plans or Related Documents (optional)

Additional Notes or Comments