Indoor Mold Assessment Data Sheet

Property Information

Property Address

City

Date of Assessment

Owner/Occupant Name

Contact Number

Assessor Information

Assessor Name

Company/Organization

Contact Number

Visual Assessment

Rooms/Areas Inspected

Visible Mold Observed

Odor Detected

Description of Affected Areas

Environmental Measurements

Room/Area	Relative Humidity (%)	Temperature (°C)	Moisture Reading	Notes

Sampling (if collected)

Sample ID	Location	Sample Type	Result	Notes

Comments/Recommendations

Date of Report

Assessor Signature