Service Call

Appliances Only.

Product Brand
Product Type
Model Number
Serial Number
Note:	Only those brands and product types in the drop-down boxes will be accepted. All others will be automatically dropped by the system. Please contact us..
Best Day To Schedule	Saturdays are by special appointment and there is an additional charge.
Best Time of Day
Note:	Day and times are preferences. They are not guaranteed.

Method of Payment - Please Select Only One

Cash or Check
Credit card		We will get your credit card information when we schedule your service call

Warranty		Only these Manufacturers for Warranty Service.
	Date of Purchase
	Dealer Name

Extended Service Plan (ESP)	Only those plans in drop-down list !	If your service contract company is not in the drop down list ...
	Plan/Contract Number
	Expiration Date

Your LAST name
Your FIRST name
Address

City
State
Zip Code

Home Telephone
Work Telephone
Cell or Pager
E-Mail Address	Note: If you do not provide a valid email address, we may be unable to contact you.

COMPLAINT or SYMPTOM