Integrity Tree Services: Tree & Shrub Report Form

TREE & SHRUB REPORT FORM

If you have a known concern regarding your trees and/or shrubs, please fill in the form below. This will allow for our Tree & Shrub Care Expert to give you a proper diagnosis of your trees and/or shrubs.

If you do not have the time to fill in the form below, you may download the printable version. It is a PDF so you must have Adobe Acrobat Reader to view it. You may obtain this freeware by clicking on the Adobe icon to the right. Please fill out the printed form and fax it to your estimator's attention at (616) 895-9602.

*NOTE: If there is a section below you don't know the answer to, please leave it blank and our Certified Arborist will fill in the blank upon inspection of your property.

Name:
Address:
City:
State:
Zip:
Home Telephone:
Work Telephone:
Fax:
Email:
Sample Type:

Plant Parts Affected
Entire Plant
Leaves / Needles
Roots
Fruit
Stems
Twigs / Limbs
Trunk
Flowers

Tree/Shrub Location
Front Yard
Side Yard
Back Yard
Lawn
Field
Plant/Mulch Bed
North
West
South
East
Natural Area

Problem Distribution
Upland
Slopes
Low Areas
Front Yard
Near Drive / Road
Side Yards
Near a Residence
Back Yard

Nature of Injury
Poor or Abnormal Growth
Wilting
Plant Death
Leaf / Needle Drop
Chewing
Rot
Yellowing
Boring
Cupping
Dieback
Galls / Cankers

Extent of the Damage
Light
Moderate
Severe

Prevalence
Entire Planting
Single Localized Area
Several Localized Areas
Few Scattered Plants

Soil Type
Sandy
Clay
Muck
Silt Loam

Drainage
Good
Fair
Poor

Type of Sample Taken, if any:
Leaves
Twigs
Soil
Other

	Other Background Info
Tree/Shrub Species:
Water pH:
Diameter/Height of Plant:
How many plants affected?
Construction near this plant in the last 5 years?
Sunny or shaded?
	Site Changes
Fertilization history:
Grade changes:
Other:
This year:
Last year:
	Chemical Use History:
This year:
Last year:
	Soil Properties
pH:
Amount of Compaction:	Light Moderate High
Soil Moisture (currently):	Dry Moderate Saturated
Watering:	Frequency
	Volume
	Root Inspection
Root Flare Visible:
Root Zone covered by:	Mulch Lawn Stone Other
Visible damage:
Fungal bodies/fruit present:

5926 Fillmore Street
Allendale, MI 49401
Phone (616) 895-9600
Fax (616) 895-9602
info@integritytree.com

"YOUR CARES are OUR CARES!"TM

TREE & SHRUB REPORT FORM

*NOTE: If there is a section below you don't know the answer to, please leave it blank and our Certified Arborist will fill in the blank upon inspection of your property.

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