Elite Appliance Repair Request Form

Elite Appliance Repair Request Form

Questions? Text us at 808-478-2833 or email us at info@eliteapplianceinc.com
Repair Rates
Repair Appointment Hours (may differ from business hours): Monday-Friday 8AM-3:30PM

Service Call & Diagnostic Fee: $199 + tax

This fee is required to book your appointment.

Additional Appliance Diagnosis: $100 per appliance

Labor Rates:
• First Hour (Minimum): $199 + tax
• Each Additional 15 Minutes: $49.75 + tax

Labor: Charges will be determined after diagnosis. Any estimated labor costs will be communicated and must be approved before we proceed with the repair.

Parts: Not included in diagnostic or labor fees. All parts will be quoted and must be approved before proceeding.

Cancellation Policy:
Cancellations must be made at least 24 hours in advance (excluding weekends and holidays). If notice is not provided within this timeframe, the $199 + tax service call fee will be charged.

Repair Considerations:
- Appliances over 8–10 years old are often not cost-effective to repair due to age, part availability, and long-term reliability. While we’re happy to assess any appliance, we aim to be transparent when replacement may be a better investment.
- We also typically do not recommend repairing microwaves, as the cost of repair is often comparable to or exceeds the cost of replacement. That said, we’re happy to diagnose and proceed with repair if preferred.
If you'd like to proceed with scheduling an appointment, please submit this form and we will email you an invoice with a link to pay online.
Point of Contact Info & Job Address

Point of Contact will be the primary contact for scheduling and any communication on the day of appointment.
Point of Contact Name*

First NameLast Name
Point of Contact Phone Number*
Point of Contact Email*
example@example.com
Job Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Billing Info

Only required if different than the info listed above
Billing Info
If the billing information is different, please include the same details requested above from the “Point of Contact Info & Job Address” section. Note: If you complete the billing section, we’ll still assume the name, phone number, and email listed under “Point of Contact Info & Job Address” are the main contact for scheduling and any day-of communication—unless you specify otherwise. If someone else should be the point of contact, please let us know here.
Job Details
Did you purchase this appliance(s) from Ferguson?*

YesNo
What type of appliance(s) do you need serviced?*

RefrigeratorWasherDryerDishwasherRange (Stove)Wall OvenMicrowaveHoodCooktopBBQ GrillWine RefrigeratorIce Machine
What type of appliance(s) do you need serviced? (Ferguson)*

RefrigeratorWasherDryerDishwasherRange (Stove)Wall OvenMicrowaveHoodCooktopBBQ GrillWine RefrigeratorIce MachineOther
What type of washer and/or dryer do you have?*

Unitized: One single appliance—washer and dryer are built together as one piece, not separable.Stacked: Two separate units (washer + dryer) stacked on top of each other—can be detached.Side-by-Side: Two separate units placed next to each other.
Appliance Brand*
Upload picture of the serial tag

If you do not have a picture of the serial tag, type in the model and serial number below
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Model Number
Serial Number
Description of Issue
Pictures/Video of Issue

Additional info can be uploaded here too
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Warranty Repairs

Only complete this section if your appliance is still covered under the manufacturer's warranty
Proof of Purchase: Upload a copy of your invoice or receipt

Please upload a copy of your invoice or receipt for the appliance. This is required to verify the warranty start and end date. We will not be able to accept your job as a warranty repair without the required documentation.
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Additional Info

List any additional info below
Should be Empty:

Elite Appliance Repair Request Form

Repair Rates

Point of Contact Info & Job Address

Billing Info

Job Details

Warranty Repairs

Additional Info