SECTION 1 — Property Owner Information

Full Legal Name (Required)
[text* owner-name pattern="[A-Za-z\s\-' ]+"]

Email Address (Required)

Mobile Phone Number (Required)

Alternate Phone (Optional)

Preferred Contact Method
EmailPhoneText Message

Mailing Address:

Street

City / Town

Province
ABBCSKMBONQCNBNSNLPEYTNTNU

Postal Code

SECTION 2 — Property Details

Property Address

Same as mailing address?

Street

City / Town

Province
ABBCSKMBONQCNBNSNLPEYTNTNU

Postal Code

Property Type
Single-Family HomeTownhome / DuplexCondominiumAcreageLakefront PropertyEstate / Multi-Structure PropertyOther

If Other, specify:

Occupancy Status
VacantSeasonal / SnowbirdFor SaleRental Between GuestsEstate / ProbateUnder RenovationOther

If Other, specify:

Approx. Square Footage
Under 15001500–25002500–35003500+

Number of Floors
[radio* floors "1" "2" "3+" "Split-Level"]

Outbuildings (optional):

Detached GarageGuest HouseStorage ShedShop / BarnBoathouseNoneOther

If Other, specify:

Utilities Left Active During Absence (Required):

ElectricityGasWaterInternet / WiFi (for client app access)None

SECTION 3 — Visit Preferences & Tier Selection

Requested Service Tier

[radio* service-tier "Tier 0 – Basic Compliance Visit" "Tier 1 – Essential Watch" "Tier 2 – Seasonal Shield" "Tier 3 – Concierge Plus" "Tier 4 – Estate Care / Custom Package"]

Custom Directive Upload (Tier 4 only)

Visit Frequency
WeeklyBi-WeeklyMonthlyCustom

If Custom:

First Preferred Visit Date

Access Method:

[radio* access-method "Lockbox on site" "Coded entry (numeric keypad)" "Keyholder hand-off" "Other"]

Code & instructions:

If Other, specify:

SECTION 4 — Insurance Requirements

Insurance Provider
AvivaIntactTD InsuranceCo-operatorsWawanesaOther

Policy Number

Required Visit Interval
Every 48 hoursEvery 72 hoursWeeklyBi-WeeklyOther

If Other:

Upload Compliance Requirements (Optional)

SECTION 5 — Homeowner Directives

Permitted Directives:

Collect mail / parcelsRun water / flush toiletsThermostat checkVisual check of trades' work areaVehicle start-upPre-arrival home prepSeasonal observation requestsOutbuilding observation

Custom Directives (Optional)

Not Performed (Auto-Filled Notice)

EquaVita does not perform security, monitoring, alarm response, system operation, emergency services, or any functions governed under the Security Services and Investigators Act (SSIA).

SECTION 6 — Emergency Contacts

Primary Contact (Required)

Name

Phone

Email

Relationship
OwnerFamilyProperty ManagerRealtorExecutorOther

Secondary Contact (Optional)

[label] Name
[/label]

[label] Phone
[/label]

[label] Email
[/label]

Trades Contacts (Optional)

SECTION 7 — Legal & Service Agreements

[acceptance* terms "I confirm that EquaVita Home Watch provides property observation only and is not a security service."]

[acceptance* liability "I acknowledge the liability waiver & limitations."]

Digital Signature (Required)

[signature* client-signature]

Date