A free restoration intake form with 40 fields in seven sections, from safety and the callback number to date of loss, authorization, insurance and the next step. Download it as a Word form or a CSV for a spreadsheet or job software.
A restoration intake form records safety first, then the callback number and address, then the loss (type, source, date of loss, date discovered, active or stopped, what's wet), who can authorize work, insurance details and the next step. This free 40-field form downloads as Word and CSV; Botcadence's restoration answering service captures the same fields.
A restoration intake form records, for every call, whether anyone is in danger, how to reach the caller and find the property, what happened and whether it's still happening, who can approve work, the insurance details, and the next step you promised. This free form has 40 fields in seven sections, the same order our call scripts follow, and downloads as an editable Word form or as a CSV header row for a spreadsheet or your job software.
We build Botcadence, which sells an AI restoration answering service, and our agent captures these same fields on the calls it answers. The form works just as well on paper, with an answering service, or with your own office staff.
The order matters more than the field list. A frightened caller with water coming through the ceiling can hang up, lose signal or stop answering questions at any point, so the form front-loads what you can't do without:
The full scripts with the exact words are free on our call script pages: water damage, sewage backup, fire and smoke, mold and storm damage.
| Field | Answer | Why it's on the form |
|---|---|---|
| Date and time of call | Write in | Starts the response clock for the job file and for any program response time. |
| Taken by | Write in | Tells the office who to ask when a detail is unclear. |
| How they found you | Google search / Google Local Services Ads / Insurance or program / Referral / Repeat customer / Other | Shows which marketing pays for itself. |
| Field | Answer | Why it's on the form |
|---|---|---|
| Anyone hurt | Yes, told to call 911 / No | An injury, fire or gas smell is a 911 call before it is a restoration call. |
| Hazards mentioned | Gas smell / Water near outlets or panel / Sagging ceiling or floor / Smoke or fire / None | Changes what the caller is told to do now and what the crew brings. |
| Power | On / Off at the panel / Off by utility / Unknown | The crew needs to know before walking into wet rooms. |
| Higher-risk people in the home | Infant or young child / Older adult / Breathing or immune condition / None / Declined | Can move the job up the list and change who should stay out of the work area. |
| Field | Answer | Why it's on the form |
|---|---|---|
| Caller name | Write in | The person you will call back, who may not be the owner. |
| Callback number | Write in | Taken early, so a dropped call still leaves you a job. |
| Text OK on this number | Yes / No | Lets the tech send an arrival time without a call. |
| Write in | For the work authorization and photos. | |
| Caller's role | Owner / Tenant / Property manager / Adjuster or agent / Other | A tenant can report a loss but usually can't approve work. |
| Preferred language | English / Spanish / Other | So the callback and the paperwork are in the language the customer reads. |
| Field | Answer | Why it's on the form |
|---|---|---|
| Property address and unit | Write in | Where the crew goes; confirm it is inside your service area. |
| Property type | Single-family home / Condo or townhome / Apartment or multi-unit / Commercial / Other | Multi-unit and commercial jobs need other people informed and often a different process. |
| Occupied | Yes / No / Vacant or for sale | Tells you whether someone will let the crew in, and whether people are living with the damage. |
| Year built (if known) | Write in | The EPA's Renovation, Repair and Painting rule applies to paid work that disturbs paint in housing built before 1978. |
| Access notes | Write in | Gate codes, lockbox, parking and pets save the crew a wasted trip. |
| Field | Answer | Why it's on the form |
|---|---|---|
| Loss type | Water / Sewage / Fire or smoke / Mold / Storm, wind or hail / Other | Decides which script the call follows and which crew goes. |
| Date of loss | Write in | When it happened. Insurers ask for it, and it can differ from when it was found. |
| Date discovered | Write in | A leak found after a weekend away has been soaking for days; the clock for drying started earlier. |
| Source or cause | Write in | Where the water or damage came from. Record it; the technician decides the water category on site. |
| Still active | Active / Stopped / Unknown | An active loss wakes the on-call technician; a stopped one can usually be booked. |
| Water shut off by caller | Yes / No / Couldn't reach it / Not a water loss | Tells the crew whether more damage is still happening. |
| Rooms and floors affected | Write in | Sets crew size and equipment. |
| Approximate wet or damaged area | Write in | A rough size is enough on the phone; the technician measures on site. |
| Materials affected | Carpet and pad / Hardwood or laminate / Drywall / Ceiling / Cabinets / Contents / Other | Porous materials touched by sewage or floodwater usually have to be removed. |
| Fire: cleared by fire department or inspector | Yes / No / Unknown / Not a fire loss | Nobody goes in until officials say the building is safe. |
| Openings to weather or entry | Roof / Walls / Windows / Doors / None | Openings need tarping or boarding before rain or theft adds to the loss. |
| Photos received | Yes / No | Photos help the technician plan and support the claim. |
| Field | Answer | Why it's on the form |
|---|---|---|
| Person who can authorize work, and their number | Write in | The crew can't start without a signature from someone allowed to give it. |
| Insurance company | Write in | Most water and fire jobs end up in a claim file. |
| Policyholder name | Write in | Often not the caller. |
| Claim number (if opened) | Write in | Saves the office a chase the next morning. |
| Adjuster or program contact (if assigned) | Write in | Who the project manager updates. |
| Field | Answer | Why it's on the form |
|---|---|---|
| Outcome | On-call technician alerted / Inspection booked / Referred out / Message only | Every call should end with one clear next step. |
| On-call alert sent at, and who acknowledged | Write in | The acknowledgement time is the number to watch; an alert nobody answered is a missed job. |
| Callback window promised | Write in | What the caller was told. Keep it to a time you can keep. |
| Inspection date and time | Write in | For contained losses that can wait for a scheduled visit. |
| Notes | Write in | Anything the caller asked that the call taker shouldn't answer, such as price or coverage, goes here for the technician. |
On paper. Print the Word form, keep a stack by the office phone and in the on-call technician's truck, and file each one with the job. Paper is fine if someone types it into your job software the next morning.
As a spreadsheet log. Open the CSV in Google Sheets or Excel. Each column is one field, so each call becomes one row, which makes the weekly review in our restoration phone KPIs guide much easier.
In your job software. Most restoration job management software lets you add custom fields to a lead or job. Use the CSV column names as the field names so the form, the spreadsheet and the software match.
With an answering service. Send the form to the service and ask them to capture every field, in this order, on every after-hours call. Then call your own line at 2 am and check what came back.
With commercial clients. Fill in a plan before the loss: our free emergency response plan template records shutoffs, contacts and pre-approved spending for property managers.
Botcadence's AI receptionist for restoration captures these fields as structured data on every call it answers, in English or Spanish:
It runs on the Voice AI plan, $299 a month with 1,500 minutes; see pricing. For chat, text and WhatsApp intake on the same plan, see AI for restoration companies.
Questions readers ask
Safety questions, the caller's name and callback number, the property address and access notes, the loss type and source, date of loss and date discovered, whether it's still active, what's wet, who can authorize work, the insurance company and claim number, and the next step promised.
Because they're often different. Water that ran over a weekend has been soaking since the day it started, and the EPA advises drying wet materials within 24 to 48 hours to help prevent mold. Insurers also ask for both.
No. Record the source of the water instead. The technician decides the category on site under the IICRC S500 standard.
Yes. The CSV download is one header row with a column per field, so it opens as a call log in Google Sheets or Excel, and the column names work as custom field names in job software.
Yes. Give the service the form and ask for every field in this order on every call. Botcadence's restoration answering service captures these fields as structured data and sends them to your inbox, CRM or job software.
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