Painting Service Request Form
Client Information
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Service Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Service Request Details
What type of painting service are you requesting?
Interior Walls
Ceiling
Trim/Molding
Doors/Frames
Cabinets
Other
If you chose other in the previous question, please specify.
How many rooms or areas need painting?
Do you already have paint selected?
Yes, client will provide paint
No, would like Medallion Maintenance to supply paint
What finish do you prefer?
Flat
Eggshell
Satin
Semi-gloss
Gloss
Are there surfaces that require prep work?
Drywall patching
Sanding
Caulking
Primer application
Other
Please specify the surface selected above that requires prep work
If you chose other in the previous question, please specify.
How urgent is this request?
Emergency (within 24 hrs)
Within 2–3 days
Flexible / Not urgent
Property Information
Property Type:
Apartment/Condo
Single-Family Home
Commercial Property
Other
If you chose other in the previous question, please specify.
Is this property occupied?
Yes
No
Scheduling Preferences
Preferred Date
-
Month
-
Day
Year
Date
Preferred Time:
Morning
Afternoon
Evening
Additional Notes for Technician
Submit
Should be Empty: