GENERAL INFORMATION

NEW CLIENT CONTACT FORM

1800 E Army Post Road, Des Moines, IA 50320

515-344-2862
Business Name:*
Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you a not for profit organization? If yes, please include tax exempt certificate with this form. If you have several addresses of locations that we will be servicing, please list them on a separate sheet and email them to dispatch@dmrepair.net.
Service Location (If different from above.):

STREET ADDRESS

STREET ADDRESS LINE 2

CityState / Province

Postal / Zip Code

AUTHORIZATION AND APPROVAL
Who is authorized to submit a service request?*
Authorizer Telephone Number*
Email:*
example@example.com
Who is authorized to approve the service and repairs?*
If the repair is less than 500.00 (not including service fee) please repair without authorization.Please call the person authorized for repairs for any repair over the cost of the service fee.
Telephone Number of person to authorize repairs:*
Email:*
example@example.com
How do you prefer we contact you?*

Phone CallEmailText

All payments are due within 15 days of job completion. All unpaid invoices after 15 days will be subject to fees and interest. Sometimes we will ask you to pay a deposit for a job before the job is complete. The reason may be for a part that is special ordered or for a large, time-consuming project. We will notify you of any deposit required.

All labor is guaranteed for 30 days following the date of repair. Parts are guaranteed for up to 1 year, depending on the manufacturer's warranty. Please call us immediately if you have any issues or experience any problems with your repair.

Text or Call for Appointments! 515-344-2862 (if an after-hours emergency, please call for quicker service).
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