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Radon Questionnaire
Questions About Our Questionnaire? Give Us a Call !!
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First Name
*
Last Name
*
Email Address
*
Phone Number
*
SMS Agreement: I agree to be contacted by text (to learn more about our privacy policy, visit ragnarcompany.com/privacy-policy/)
Business Name
*
Website
Street Address
*
City
*
State (Initials)
*
Zipcode
*
Year Company Established
*
Total Sales
*
0-40,000
40,001-60,000
60,001-100,000
100,000+
Do You Have Insurance?
*
Yes
No
If So, With Who?
Have A Completed Radon Application? Feel Free To Share It With Us!
How Do You Hear About Us?
*
AprilAire
Radon Insurance Page (AARST Website)
The Rn Biz Email (AARST Email)
Referral
Google Search
Social Media
Other
If Other, Please Let Us Know How You Heard About Us
Additional Comments or Message