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This one simple form will lead to answers to your most complex problems. Once submitted, be on the lookout for a confirmation email. If you have any questions, do not hesitate to reach out to us at 888-806-5654 or info@polarisforensics.com. We appreciate the opportunity to assist you with your project!

PROJECT SUBMISSION FORM

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Name

This field is for validation purposes and should be left unchanged.

YOUR INFORMATION

Name*

First Last

Company Name*

Company Mailing Address*

Street Address Address Line 2 City State ZIP Code

Email*

Primary Phone*

Please use format 111-111-1111

Alternate Phone

Please use format 111-111-1111

PROPERTY INFORMATION

Insured / Project Name*

Loss/Project Address*

Street Address Address Line 2 City State ZIP Code

Site Contact Name*

First Last

Site Contact Role*

Other Contact Role:

Site Contact Phone*

Please use format 111-111-1111

Site Contact Email

Additional Site Contact Information or Notes

ASSIGNMENT INFORMATION

Claim or Your Project Number*

Date of Loss or Occurrence*

Estimate of Fees Required Prior to Proceeding?*

Yes

Scope of Assignment and Notes*

Special Accessibility Requirements or Notes

File Upload 1

Accepted file types: jpg, pdf, png, gif, csv, xlsx, Max. file size: 32 MB.

File Upload 2

Accepted file types: jpg, pdf, png, gif, csv, xlsx, Max. file size: 32 MB.

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PROJECT SUBMISSION FORM

YOUR INFORMATION

PROPERTY INFORMATION

ASSIGNMENT INFORMATION

Parasar Gosain, Ph.D., P.E.

Project Director Fort Lauderdale, FL

Project Director
Fort Lauderdale, FL