Home Visits Worksheet
Print this worksheet to take with you during a home visit
or complete it as soon as possible after a visit.
Price
From $ _____________
To $ _____________
Location
Street Address
__________________
 
 
__________________
 
City
__________________
 
State
__________________
 
Zip Code
_______________
 
Type/Style of Home 
_____________________

(For example: bungalow,
one-story, split-level)

Age of Home
New___ Existing___ Age (in years)_____
Construction
Excellent___ Good___
Improvement Needed___ Poor___
Rooms
Bath_____
 
Bedrooms_____

Den/Study___
 
Dining___
 
Family___

Living___
 
Laundry___

Finished Basement___


Other_____________________
Extras

 
 
 
 

 

Alarm System___ Air-conditioning___
Car Port___
 
Driveway___

Ceiling Fans___ Fireplace___
Garage___


Kitchen Appliances (refrigerator,
stove, dishwasher, etc.)

_____________________


Porch/Deck/Patio___ Pool___
Storage Space___ Washer/Dryer___


Other_____________________
Heat
Forced Air___ Radiator___

Other_____________________
Fuel
Electric___ Heat Pump___ 
Natural Gas___ Oil___

Other_____________________
Neighborhood
(comments)
 
Schools
(comments)
 
Proximity to Transportation
(comments)
 
Proximity to Community Activities
(comments)
 
Additional Comments