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Blankenship PCS: Act Fast!
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1
Contact Information
First Name
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Last Name
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Email Address
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Phone Number
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2
Project Address
Address
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City
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State/Province
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Postal Code
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How did you hear about us?
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Select...
Google
Facebook
Word of Mouth
Yard Sign
Repeat Customer
Website
Instagram
Phone Call
Mail
Other
NIM - Facebook Lead
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Select the service you are interested in.
*
Select..
Polished Concrete
Sealed Concrete
Solid Color Epoxy
Flake Flooring
Metallic Epoxy
Epoxy Quartz
Other (Please specify below)
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Please select the size range that best describes your project area.
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Select..
• 100-200 sq ft: About the size of a small home office or a large walk-in closet.
• 200-400 sq ft: Comparable to a small studio apartment, a one-car garage, or a large bedroom.
• 400-600 sq ft: Similar to a large studio apartment, a two-car garage, or a small living room and kitchen combined.
• 600-800 sq ft: Fits a one-bedroom apartment, a spacious studio, or a combination of a living room and a bedroom.
• 800-1000 sq ft: Comparable to a two-bedroom apartment, a small townhouse, or a living room, kitchen, and dining area.
• 1000-1500 sq ft: About the size of a small single-family home with two bedrooms, a living room, and a kitchen.
• 1500-2000 sq ft: Similar to a medium-sized single-family home with three to four bedrooms, a living room, and a dining area.
• 2000-4000 sq ft: Fits a larger single-family home with multiple bedrooms, a living room, a home office, and an entertainment room.
• 4000-6000 sq ft: Comparable to a luxury home with four to five bedrooms, including spaces like a home theater, gym, or large outdoor patio.
• 6000 sq ft and above: Please specify further details.
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Briefly describe the goal of your project
(optional)
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What is your preferred start date for project? (REQUIRED FIELD)
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Select..
Urgent - I need service as soon as possible.
Within the next 2 weeks.
1-2 months from now.
2-3 months from now.
More than 3 months from now.
Got an exact date in mind? no problem. (Specify below)
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Please specify if there is a specific date by which the project must be started or completed. Provide the date(s) below.
(optional)
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Select the area(s) of your property that requires our services. (REQUIRED FIELD)
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Basement
Garage
Kitchen
Patio
Driveway
Sidewalk
Pool Deck
Living Room
Dining Room
Commercial Space
Industrial Floor
Warehouse
Office
Retail spaces
Other (Please specify below)
This question is required
Could you detail any particular project requirements or logistical considerations we should account for, such as preferred scheduling, sensitivities to certain materials, or any access difficulties, including narrow passages, steps to elevated areas, side-only entrances, steep slopes, or other specific site conditions? (REQUIRED FIELD)
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3
Project Photos
Attachments are required
Form completion requires uploading current floor condition photos.
*
I agree to receive text messages from Blankenship Polished Concrete Services, LLC.. Standard rates may apply. Reply STOP to opt out. View our
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Privacy
Terms and Conditions
SMS Terms & Conditions
These messages may include project related updates, appointment reminders, and other important project related information.
You can cancel the SMS service at any time. Just text "STOP" to any text message you receive. After this, you will no longer receive SMS messages from us.
Carriers are not liable for delayed or undelivered messages.
As always, message and data rates may apply for any messages sent to you from us and to us from you. If you have any questions about your text plan or data plan, it is best to contact your wireless provider.
If you have any questions regarding privacy, please read our privacy policy.
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Privacy Policy
Information We Collect
Personal Information:
We collect your phone number and any information you voluntarily share through messages.
Automatic Information:
We may automatically collect data such as message timestamps, delivery status, and usage patterns.
How We Use Your Information
Service Delivery:
To send and receive messages, provide support, and improve our service.
Communication:
To communicate service updates and account notifications.
Analytics:
To analyze service usage and enhance user experience.
Sharing Your Information
We do not sell your information. We will not share your information with third-parties or affiliates for marketing or promotional purposes. We may share your data with third-party service providers for purposes of delivery, analytics, or legal compliance, ensuring they adhere to strict confidentiality obligations.
Data Security
We implement safeguards to protect your information against unauthorized access, alteration, or disclosure. However, no method of transmission is completely secure.
Your Choices
You may opt out of marketing messages at any time by replying "STOP." Note that opting out may limit some service features.
Changes to This Policy
We may update this Privacy Policy periodically. Changes are effective upon posting. Your
use of our service signifies acceptance of this policy.
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