Water & Fire Emergency
On-Call 24 Hours 1-800-393-5993
Board Ups
Water Extraction
On-Site Drying
Wet Carpet Removal
Document Restoration
Structure Cleaning
Pack Out
Deoderization
Mold Remediation
 
"Your workers are diligent, honest, and courteous people. It was pleasure to work with such nice people. They are a credit to your company"

QRS Customer
Pasadena, California
 

In order to initiate work with QRS, please fill out the form below. Make sure that all information is accurate and when complete click on the submit button. A QRS representative will review all information and contact you within one business day. Once we have a complete understanding of all structural damage or personal property damage, we will provide a written estimate.

Once we begin work, we will set up your acount and issue you a user name and password so all documentation can be viewed online. If you havea ny questions, call QRS at 1-800-393-5993.

Insured:* Job No:
Loss Address:* Hm:*
  Wk:*
Map Page:* Cell:
Temporary Phone: Fax:
Temporary Address:
 
Type of Loss:*
Areas Affected:
Date of Loss:* Claim/Policy #:*
Contact:*
 Staff Adjuster   Independent Adjuster   General Adjuster   Other 
Company:*
Address:*
 
Phone:* Fax:
Cell: Pager:
Notes:
Called in by: Date/Time:
Received by: Phone:
SM