Sage Living EMF Intake Forms

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

Room #1 of 6



       
Equipment Used:
Notes:

Room #2 of 6



       
Equipment Used:
Notes:

Room #3 of 6



       
Equipment Used:
Notes:

Room #4 of 6



       
Equipment Used:
Notes:

Room #5 of 6



       
Meter used:
Antenna used:
Notes:

Room #6 of 6



       
Equipment Used:
Notes:

Next steps

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