New Hoover Request Form

1
Full Name* This field is required.
First Name
Last Name
2
Email address for confirmation* This field is required.
example@example.com
3
Name of site that broken Vacuum is located. Include Postcode
name of site
Post code or town of site
4
What seems to be the fault with Vacuum* This field is required.
No Power
Power But makes funny noises
Power but no suction
Metal Pipes are blocked
Ripped black Hose Pipe
Physically Broken (Handle snapped off)
5
Your hoover has no power - Can you confirm you have tried plug socket in a different room or location. We do this as the power socket may not be working.* This field is required.
YESNO
6
Your hoover has Power But makes funny noises - This may because something is blocking the tupes OR the motor is sucking to much dust. Please confirm that you have now check the pipes & Hoses for blockages and that your hoover bag is empty* This field is required.You must only click yes if you have completed this step.
YESNO
7
Power but no suction - This may because something is blocking the tupe OR they hoover bag needs replacing. Ensure you check the white filter as sometimes these get covered in thick dust in which can effect the performance. These filters need washing in a sink and kept in a warm place to dry (Do not use if still wet, this will damage the motor). Please confirm that you have now check the pipes & Hoses for blockages and that your hoover bag is empty* This field is required.You must only click yes if you have completed this step.
YESNO
8
Metal Pipes are blocked - If your pipes are blocked then take apart the poles and black hoover pipe. Stick a mop handle down the pipe or the metal poles to clear any blockages. Please confirm you have attempted to clean a blocked pipe yourself.* This field is required.You must only click yes if you have completed this step.
YESNO
9
Ripped black Hose Pipe - Are you able to repaire this? Sometimes the end will come off the hose pipe. This can oftern be twisted back on by turning antu clockwise. Please confirm that you have tried this and it has not been possible to repair this yourself?* This field is required.You must only click yes if you have completed this step.
YESNO
10
Physically Broken - if the hoover is broken physically please give us a discription of how the hoover is broken? Is it a threat to you and other on site or does it cause a performance problem when using the hoover. The more information the better
Huge
Large
Normal
Small
Ok
Ok
11
Is there anything else we need to know before collection this hoover and replacing it.
12
What to do next:

1) Make sure you empty the hoover bag and throw the bag in the bin.

2) Write on a piece of paper " FOR COLLECTION - TODAYS DATE" ensuring you include todays date.

3) Click next and take a picture of the hoover and detail where you will be leaving it for collection.
13
Take Photo on the hoover
14
Detail where the hoover is located for collection. Ensure that it is easy to get to and we do not need to climb to the back of the cleaning cupboard to locate it. It should be in the front of the cupboard with the sign clearly showing that it needs to be collected.
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: