SERVICE REQUEST
NEW OR EXISITING CUSTOMER?
NEW
EXISTING
Full Name
*
First Name
Last Name
Address
Street Address
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
TYPE OF APPLIANCE NEEDING TO BE SERVICES
PELLET
GAS (If you did not purchase your gas- stove, insert or fireplace with us, we are unfortunately not able to offer service at this time)
MAKE AND MODEL
DESCRITION OF PROBLEM
Please verify that you are human
*
Please indicate if you have a preferred day/days of the week. We will try our best to accommodate if we can.
Submit
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