SCHEDULE A SERVICE CALL

 

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Please fill in all areas AS ACCURATELY AS POSSIBLE-

 

NAME:                            DAYTIME PHONE:

ADDRESS:                    ALTERNATE PHONE:

CITY:     ZIP:                      EMAIL:

BRAND of APPLIANCE:   

SPECIAL INSTRUCTIONS:

DESCRIBE THE PROBLEM:

 

 

  

Once you click SEND, the service technician will be instantly notified and will call you for the appointment verification.