(352) 473-3681
Appointment Request Form
Fill the form below and a representative will contact you to schedule your exact appointment time and date.
Name
First Name
Last Name
Phone Number
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County
Please Select
Alachua
Bradford
Clay
Dixie
Putnam
Other
Please list your county
Email
example@example.com
Are you an existing Rays Electric customer?
Yes
No
Describe the work that you need us to do
Preferred Appointment Date - YOUR SELECTION DOES NOT GUARANTEE that we will book your preferred date and time. A representative will contact you to book an official appointment.
Please verify that you are human
*
Submit Form
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