Insurance Appraisal Form

Fill out the form below to provide the information we need to appraise your instrument(s). The fee is $25 for up to 2 instruments. This form requires payment of the fee to submit. If you need to appraise additional instruments, submit another form with payment. We will complete your insurance appraisal and deliver it to you via email to the address provided below, within 5 business days. Please feel free to contact us with any questions.

First Name

Last Name

Email

Phone/Mobile

Address

Address Line 1

Address Line 2

City

State

Zip Code

Instrument #1

Please provide as much information as you can on each item you submit.

Instrument #1 Basic Info

Flute

Piccolo

Headjoint Only

Other

#1 Make

#1 Model

#1 Serial Number

#1 Open or Closed Hole

Closed Hole

Open Hole

#1 Footjoint Type

C Footjoint

B Footjoint

#1 Additional Features

C# Trill Key

French Pointed Arms

Split E

D# Roller

#1 Additional Features/Comments

#1 Headjoint Features

#1 Headjoint Make

#1 Headjoint Material

#1 Additional Headjoint Features/Comments:

Instrument #2

Optional Instrument

Please provide as much information as you can on each item you submit. If you don't have a second instrument to appraise please skip this section.

Instrument #2 Basic Info

Flute

Piccolo

Headjoint Only

Other

#2 Make

#2 Model

#2 Serial Number

#2 Open or Closed Hole

Closed Hole

Open Hole

#2 Footjoint Type

C Footjoint

B Footjoint

#2 Additional Features

C# Trill Key

French Pointed Arms

Split E

D# Roller

#2 Additional Features/Comments

#2 Headjoint Features

#2 Headjoint Make

#2 Headjoint Material

#2 Additional Headjoint Features/Comments:

Payment and Terms

Product / Service Fee

Price: $25.00

Payment Method

Pay with Card (Stripe)

Pay with PayPal

I Agree to the following Terms and Conditions *
*Appraisal is based on current retail “replacement value” determined from your information provided to us through this insurance appraisal request form. Current retail price is replacement value. For discontinued products, we will use comparable replacement value. Please note, current retail prices are subject to change without notice. Your credit card will be charged the instrument "Insurance Appraisal" fee upon submission. If the fee cannot be charged the submission will fail.