Roof Rhino - Integrity Personal Insurance

Name*
First Last
Phone*
Email*
Date of Loss*
MM slash DD slash YYYY
Address*
Street Address City State ZIP Code
Insurance Company*
Claim Number*
Claim Adjuster Name
First Last
Adjuster Phone*
Adjuster Email*
Shingle Type*
Total Squares*
Please enter a number from 1 to 100.
Is the slope or pitch of your roof listed on your claim document?*
- Yes
- No
Squares at Roof Pitch (Slope) 7/12-9/12*
Please enter a number from 0 to 100.
Squares at Roof Pitch (Slope) 10/12-12/12
Please enter a number from 0 to 100.
Squares at Roof Pitch (Slope) 13/12 - 15/12*
Please enter a number from 0 to 100.
Squares Remaining
This value is calculated automatically based on the squares values you entered in the previous questions. The value will be 0 if you entered the squares information correctly.
Does your home have more than 1 story?*
- Yes
- No
Number of Squares on 2nd Story*
Please enter 0 if your home doesn't have a 2nd story.
Continuous Ridge Vents (LF)*
Please enter a number from 1 to 500.