Customer Request Form

(please choose one or more of the following)

Services *

Monitor Rentals & Sales

Pest Control Services

Inspection Request

Free Estimate/Quote

Information Request

Supplies & Devices

CUSTOMER/CONTACT INFORMATION

To help PPM Ottawa Bed Bug Experts, please complete the below form and click "submit".

Your Full Name *

Company Name

Your Title

Street Address *

City *

Province *

Postal Code *

Email *

Phone or Cellular *

Ext.

Fax

Website

Customer Bed Bug Details & Comments

CONTACT PREFERENCE

(please choose one or more of the following)

Contact Preferences *

Please have a PPM Ottawa Bed Bug Expert phone me

Please have a PPM Ottawa Bed Bug Expert email me