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North Carolina Bed Bug Survey

 

Your Name:

 

 

Contact Information:  

 

 

Phone:

Email:

 

 

Type of building: 

 

 

    If other, please specify: 

 

 

 

North Carolina County:

Zip code: 

 

 

 

 

Nature of the problem:

How long have you suspected or seen evidence of bedbugs?

 

 

 

 

 

 

 

 

 

Any action you have taken:

 

 

 

 

Comments or additional information:

 

 

 

 

 

 

 

 

    North Carolina Mosquito & Vector Control Association
    PO Box 40245
    Raleigh, NC  27629-0245
    NCMVCA Webmaster .