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Living Harmony ~ Property Appraisal Form

Name

Name & ages of
household members
(including pets)

Address
(Please include postcode)

Telephone / Fax

Email

Best time to contact you

Reasons for requesting a property harmonisation

 

About the Property

 

Age & type of property:

How long have you lived there?

Do you own or rent?

Any particular reason why previous owners/occupiers left?

Number and types of room

Do you have a garage

Is there a basement?

Where are the electricity meter and fuse box located?

Are any rooms located above electric meter or fuse box?

Do you have a satellite dish?

Any home improvements
within the last 5 years?

 

Possible symptoms of environmental stress in your family

 

Does anyone in your household suffer from :  

 Insomnia

 Nightmares

 Depression

 ME

 Lethargy

 Learning difficulties

 Headaches

 Cancer

 Grogginess

 Impaired creativity

 Aching joints

 Miscarriage

 Restlessness

 Hyperactivity

 Allergies

 Accident prone

 Chronic fatigue

 Glandular fever

 

 

 Other ailments / conditions

Which family member(s) suffer from the above?

 

 

 

Man made sources of electromagnetic-stress

 

Any known or visible elements within 200m of the property?

 

Geopsychic activity

 

Please describe any paranormal activity or experiences in the property?

Upon completion please print this form then sign and date below

             

Signed

 

 

 

Print name

Date


Upon completion please send to (see contact for address) with a £35.00 cheque made out to Living Harmony.

Living Harmony wish to make it clear that any information you provide is considered to be used only to fulfil your requirements and to communicate with you. At no time will any information shared in confidence with Living Harmony be disclosed or sold to any third party. For our detailed Privacy statement click here


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