Sage Living EMF Intake Forms (E Rdgs)

Client info
Electric and Magnetic Field Overview
Exterior readings
Interior readings
Interior AC Fields
Breaker assessment
Tips
Summary

AC Electric Fields:

Location:
Power ON
Grounded:  Free:  
Power OFF
Grounded:  Free:  
Notes:

Location:
Power ON
Grounded:  Free:  
Power OFF
Grounded:  Free:  
Notes:

Location:
Power ON
Grounded:  Free:  
Power OFF
Grounded:  Free:  
Notes:

Location:
Power ON
Grounded:  Free:  
Power OFF
Grounded:  Free:  
Notes:


Next steps

Client info
Electric and Magnetic Field Overview
Exterior readings
Interior readings
Breaker assessment
Tips
Summary