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Trade job forms · TJ-28

Pest Treatment Visit Record

A free printable pest control visit record — the pest reported and found, each area inspected, every product or device placed and the advice given.

First page of the Pest Treatment Visit Record — Leave a treatment record that can be checked against the product label. The next technician, or a customer asking what was put down and where, can read it without you.
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One page. Choose your paper size — both versions are laid out identically, so neither one gets shrunk to fit.

Print it and write on it

Fill it in type and save

The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.

What this sheet is for

Leave a treatment record that can be checked against the product label. The next technician, or a customer asking what was put down and where, can read it without you.

Who it is for

Pest control technicians and small pest firms, and facilities or property managers who want the contractor's visit written up.

How to use it

  1. Record the pest reported, what you confirmed, and who or what is on site — children, pets, livestock, food.
  2. Take one line per area inspected: the evidence, whether it is fresh, and where they are getting in or living.
  3. For each product or device, write the active as labelled, where it went, the quantity used and the station reference.
  4. Note the proofing and safety advice given, where notices were placed and the follow-up date, then have the customer sign.

What is on the sheet

One page, top to bottom:

Printed under the title: One technician's visit: what was found, every area inspected, every product put down, and what the customer was told.

The label's figure, your record. How much product goes down, where it may go and what the customer must be told are on the label and in the rules where you work. This records the quantity you used and where, so it can be checked against the label; nothing here repeats it.

Write-on lines: Customer · Address · Date · Technician · Pest reported · Pest confirmed · Visit no. / contract · On site: children, pets, livestock, food

Areas inspected — one line per room, area or void

Table, 3 rows: Area · Evidence found · Activity · Entry / harbourage · Action

Products and devices — one line per product used or device placed or checked

Table, 3 rows: Product / device · Active as labelled · Where placed · Qty used · Station / trap ref · Checked

Write-on lines: Advice given: proofing, housekeeping, safety · Notices placed where · Data sheet left? · Follow-up date

Signature strip: Customer signature · Print name · Technician

Questions

Why does the sheet not say how much bait to use?

Because the quantity, the placement and the warnings all come from the product's label and the rules where you work, and they differ product by product. The sheet records what you used and where, so it can be checked against the label rather than standing in for it.

How is this different from the pest control log?

The log is a site's own running record of sightings and visits over months. This is one technician's visit written up in full — areas, products, devices and advice — and it is the sheet the log entry refers back to.

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