The WelGard® Protection Plan Testing Order Form Homeowners Testing Plan Form HOMEOWNERS CONVENIENCE FORM - ORDER YOUR TESTING AND WELGARD Let’s get started ! ( It only takes 2 minutes ! )Homeowner's Name* Homeowner's Telephone #*Homeowner's E-mail Address* Property Address:* Street Address City State / Province / Region ZIP / Postal Code When would you like to conduct the testing?1ST Preference of date of test MM slash DD slash YYYY Time : Hours Minutes AM PM AM/PM 2nd Preference of date of test MM slash DD slash YYYY Time : Hours Minutes AM PM AM/PM What Services do you need?Yield Test Yield Test - minimum 3 hour; required in Baltimore County) - 550.00 Modified Yield Test (approx. 90 – 120 minutes; qualifies for WelGard® Protection) - $400.00 Potability Test Standard potability - (includes coliform and e-coli bacteria, pH, Nitrates, Sand and Turbidity) - $275.00 Lead Test Optional Lead Testing (required for VA/FHA) - $70.00 WelGard Protection Plan WelGard Protection Plan - Annual $539.00 WelGard Protection Plan - Monthly $49.99 Promo Code Discount/Benefit may not be applicable or reflected on this form. Discount will be reflected on final invoicing and charges to credit card.Reason for Testing Real Estate Transaction Routine Maintenance Qualify for WelGard Protection Plan I/We are Considering Selling our Home Other Total : $0.00 Credit CardCard Details Cardholder Name Any known problems with the well? Yes No How did you hear about us?* Friend Relative Realtor Neighbor Online Web Search Other If WelGard® is not completing the testing, check here and remit any testing to [email protected] Please review your order and click "Submit" once to complete. Δ RealtorsGot clients dreaming about a home with a residential well? No problem. Set their mind at ease with an inspection and potability testing. Contact us Today NEW! Weekend Service WelGard® Protection, even on the weekends. Test Sunday - Know Monday. Inspections, potability, and yield. Call (410) 630-6900. Get Started Now. WelGard®: Protecting Your Well Today From Tomorrow’s Problems Get Started Now.
