Mercury Remediation Intake
Please fill out and submit this intake form after you have checked out and received your order confirmation number. You won't be taken to a new page after you submit - your submission confirmation will appear right here, though you might have to scroll up to see it if you're on mobile.
Even if you are booking this work for someone else, put YOUR last name, first name, email address, etc. in those blanks, not theirs. Add their info in the spot for goal/petition, instead. The name and email associated with this form needs to match the info in my system for you as a customer/client, since you are placing the order. This is going into your client file, not theirs, since I'm not communicating with them and they aren't my client.