NACHI Four Point Form

Assurance Check has automated the NACHI Four Point Form. It is now web based and is available to all NACHI Members.

You just enter the required data on each page. On the last page is a submit button. The report will be e-mailed to you in a PDF file once you click the submit button.

When filling out the form only place the 10 digits into the phone number field. The form will format the field in the form.

You can add your pictures once the PDF File has been E-mailed to you. There are three image fields in the form. A box will appear when you click on the image field. In the box you select where the image is stored and click on the image you want placed in that field.

You can add a digital signature for the signature field. The Adobe reader has a wizard that will show you how to create a digital signature.

Once you add the photos and signature just print as a PDF file again and the form is locked so that no one can make any changes.

The user guide is almost complete for the form. It will be posted once it is complete (should be by Monday).

I am releasing it now so that some of you can use it and let us know if you see or have any problems.

I also created a checklist that flows with the form.

We also automated the OIR-B1-1802 form used for a Insurance Discount Survey (Wind Mit). It is also available to all NACHI Members. Just follow the same instructions as above.

I hope that you find that the forms are useful being web based. Please let us know what you think about them.


Greg your form has different data than the NACHI approved form

What gives??

Also if one is filling it out on site with a laptop one might not have an Internet connection to fill your form on line

Since the four point inspection lends itself to on site and many of us have laptops the time to produce form can be reduced if your system could be as a stand alone

Any reason for having it on line?

MS Word can produce a PDF report

Also I have a small concern about the on line security of the data

Final note – Should we put InterNACHI in place of NACHI on the header?

Right now I think Citizens will take almost anything if it is good eye candy and has basic information



The online form is good, but I have two suggestions:

Many times there are mixed type drain pipes. The form does not allow for more than one type.

On the electric and plumbing, we can only guess as to the year of the upgrades. There are only years llisted going back ten years. What if the system was upgraded 20 years ago? Is there anyway to changed these areas?


“Right now I think Citizens will take almost anything if it is good eye candy and has basic information”

This is a false statement. If you do not use the proper form, it can (and will) be kicked back. It may take three or four months to happen, but it will get kicked back to you.


Thank you very much.

Thank all of you for taking the time to look over the form and for your comments.


Joe built the form so I will let him explain why the fields are different.
The only difference I see is that the form wants the insurance agent contact info. Is that what you are referring too? I didn’t post an objection simply because it makes me collect that data (which before the form I never asked). Then I use that data to market to that agent. I let the agent know that I did a inspection for one of their clients and try to get on their referral list.

Our original intent was to have a customized form for anyone that took one of our courses. Then we realized how much time it would take to do that, so we looked for other solutions. That is how we came up with what we have now. It didn’t take a lot of man hours to accomplish. By taking this route we can give it to all NACHI members at no cost to them.

Yes you are correct that word can be used to produce a report. Anyone that wants to go that path can do so.

What data are we collecting that is not available on line somewhere else? So I am not sure what your concerns are about security. I do believe that the process is done on a secure server. Joe will be able to give you a better answer on that than I can.

The name will be changed if we are ever directed to do so by someone of authority.

I hope that I have answered some of your questions.


I agree that those are two areas that could use some improvement. Changes are very easy to make with the system Joe has set up. Those changes should be made shortly.


You are welcome and thank you for your help.

I have started to use this form for all of my four point inspections. I just think that it looks better than anything else I have seen or used.

Here is a link to a users guide that is in a flash file. It explains how to use the form. Four Point.swf

Hi Bill,

Thanks for your suggestions, multiple selections are possible but I would like to keep the selection process as simple as possible, what mixed drain pipe combinations would you like for me to add to the list?

In regards to upgrades, I do not believe that upgrades that occurred over 10 years ago are worth noting, but how about I add a +10 & a +20 years field to show that the upgrades occurred quite some time in the past.

I really appreciate you sharing your thoughts here, we are in our roll out testing phase and are seeking all the help we can get to get it right.

Thanks again,

Joe Burkeson, Assurance Check, LLC


Good eve


A few questions

Are we required to include

  1. Pictures (three)
  2. AC Capacity
  3. Heating Capacity
  4. Agent information
  5. Survey Notes
  6. Definition of Findings
  7. Working AC not required for insurance - sometimes only a window unit or two — Installed HEAT is
  8. Freeze hazards - down here normal answer is yes (Florida homes are full of them - not a problem until the next ice age) Don’t know about northern Florida

I do not quite understand where we would use the “Not Present” condition finding on this report since it is only the 4 points - perhaps a missing roof or a no plumbing condition could exist

Would also like some guidence short of going to my electrical brain of what would give a “No” answer on “Is the electrical service sufficient” – Lets say 150 amp service - 4 bedroom - etc.

Some how we have taken a one page form and made 4 pages when the only thing that Citizens wanted on day one was some basic information and some signatures and license numbers

I like expanding the inspection. It looks impressive and thus worth more money. Image and professionalism

I know that I am bringing to the table little thing that in the long run are of little note but maybe some thought in these area is in order

Still did not understand why you feel that this should be done on line??

While some of the data is public - The condition report IS NOT - Since my client (the home owner) has payed for it, he controls who sees it.

Example: I say the home is a POS - He goes out and gets another inspector that says “No Problem” - I am sure he would not want my report going to his insurance agent – In short he might not want me to know who his agent is to start with.

Just thoughts

Remember getting insurance even Citizens in this state is a big dea

In short I know that your form was generated from the NACHI form. I wonder where it came from and if it could be changed and reapproved by Citizens. In some cases we might be looking like we are suppling needless information



It is nice to see that some things never change. I guess that it is not for you. Good luck with what ever path you choose.


And perhaps this program is not for other inspectors that see problems

Somehow I now feel that we are walking into a gas chamber

Maybe not the intent but maybe the results

Why is it only me that asks the little questions that are upsetting to you?

Greg all I want is some little issues addressed and you come back with no answers

The real question is why you and Joe are so nice to all Florida NACHI to make this little software form only ONLINE when anyone could do the same thing OFFLINE. We are not all computer dumb.

Your post razes many red flags about the data that is not secure and the WHY of the project

Now I am thinking about the whole Florida State Chapter Program has a hidden agenda

I hope I am wrong but why do we need it when so many local chapters have failed?

Yes you are correct I am the same - be it questions of:

Who is driving the ship?
Where is Harvey who started the state chapter and all its directors and members?
Where are the Florida chapters that were started and died and their founders?
Who were the members of any of these chapters?
Were there any or were this chapters just to get the term president on a business card?
Why support bad state HI regulation?

Look at it this way we are all just trying to make a living.
We can do it without killing each other or selling something to other HI’s something that they do not need.

Somehow I now do not see a need for a Florida Chapter – we already had one and it sunk - Why another one –

If there is good logic I will be the first to support

I do not understand your short answer

You have in the past always have been up to expressing your ideas and thoughts

And yes it should be InterNACHI - Why wait for the lawyers to call - Remember Nick does not read all the posts and who in our small group has the time to bother him with small problems that are quite clear

NACHI is no longer - it is InterNACHI as per a court of law

We were too close to NAHI - Thank goodness that we are not as close any more


Not trying to shoot you down but do you see how things are looking?

If I think that you have a good idea, I will say so - like the eye candy part of your report is very good or should I tell Joe??



About one month ago I created an Adobe Acrobat Four Point Form based on the approved NACHI Four Point fields FOR MY COMPANY USE, at the time inquiry’s came poured in asking for a copy of our form.

It was our business decision not to release an uncontrolled open PDF document with an Assurance Check Copyright at the bottom for anyone to use and change. I believe it is counter productive to have hundreds of different forms in circulation.

The only way I was willing to share my form was in a secure environment, to do that would have meant creating a customized secure document for over 100 people… We found a better solution, the decision was to place the document on line, that way I only ever had to control and update one copy of the form.

You are welcome to freely use what we created as it is without charge, you are not welcome to dictate to Assurance check your demands or throw a hissy-fit when you don’t get your way. As a consolation if you would like for Assurance Check to customize a file just for you, please contact me privately and we can discuss the cost & time-frame.

Joe Burkeson, Assurance Check, LLC.


Easy solution, dont use the format. There is one you can use under the (Whats new section)

Greg and Joe have created a FREE program for NACHI members and you are complaining…come on. As far as the FLNACHI chapter, why not have another one. A Florida chapter is what we need most. There are far to many NACHI chapters scattered through out the state. We should consolidate all the chapters into a strong well organized Fl chapter IMHO. I am sure Greg, Joe, Jayt and some others some ideas that will create a strong chapter. Even if it means paying additional dues.

Thanks Greg and Joe for sharing your format with us.


Your history speaks for itself. That is why I gave you the second reply. You have never been happy with anything that I do. I am not going to waste my time debating with you. As it has already been stated you either use the form or you don’t.

As for the state chapter I don’t care if you join or not. I do not recall you ever attending a chapter meeting in the past or ever providing anything positive to NACHI. The only thing I do know that you do is bitch on this message board.

Now that I have moved my body off the street after being run over by a large truck with a NACHI bumper sticker, I will re-address my postings

Sorry to have upset Greg and Joe.

I feel sure that if data is collected from their 4 point web site that it will be used in a most positive way

I wish I have thought of copyrighting a form and thus all the data on it. That was very smart.

The copyright laws are very clear that the completed email that is sent to the inspector is copyrighted including all the data.

The value of data could be high and I do not see a problem with collecting and using it.

I will say again that Greg and Joe are good instructors and that I have learned a lot thought their example

I am sorry that they don’t want to debate some of these issues – I enjoy being challenged and even sometime getting hit by a truck. I feels so good after the pain goes away

Good job - I have lost this battle. The white flag is up


The finished product is looking good


Has anyone used this 4-point inspection form for Royal Palm Insurance? I’ve always done them for Citizen. Does Royal Palm accept this form as well?