Bed Bug Report

• Inspected by:

• Apt Number/Tenant Name

• Conducted on

  Date

• Tenant Cooperation

  Select Compliant Non-Compliant N/A

  • Compliant
  • Non-Compliant
  • N/A

• Inspection type

  Routine

  Complaint Response

• Check for bed bugs, eggs and/or signs of bed bugs in the following areas

• Beds (including the mattress and its seams, bed sheets, and box spring)

  Clear

  Contaminated

• Bed frame

  Clear

  Contaminated

• Pillows (including the inside of sheets)

  Clear

  Contaminated

• Head board

  Clear

  Contaminated

• Foot board

  Clear

  Contaminated

• Night stand

  Clear

  Contaminated

• Lamp shade

  Clear

  Contaminated

• Walls

  Clear

  Contaminated

• Wall hangings (pictures, posters, paintings)

  Clear

  Contaminated

• Sofa

  Clear

  Contaminated

• Upholstered chairs

  Clear

  Contaminated

• Carpets

  Clear

  Contaminated

• Outlets

  Clear

  Contaminated

• Dresser

  Clear

  Contaminated

• Closets

  Clear

  Contaminated

• Other areas/items where bed bugs and/or signs of bed bugs are present?

Sign off

• Full name and signature of inspector

  Sign