Damage to Bluegum Property Form
This form is for you to report damage to Bluegum Property, this includes, vans (excluding road accidents), tools, equipment or the Bluegum warehouse.
Name
*
First Name
Last Name
Email
*
example@example.com
The Item has been
*
Please Select
Damaged
Lost
What Bluegum asset has been damaged?
*
Please Select
Tools
Equipment
Vehicle
Warehouse
Office
Stock
Other
If other, please provide details below
Please explain what has been damaged and how the damage occurred
*
Where did the damage occur?
*
Please Select
Warehouse
In Transit
On-site
Other
If other, please provide details below
If appropriate, have you done anything to repair the damage, if so what?
*
What needs to be done to repair the damage?
*
What is the level of urgency for the item to be repaired?
*
Please Select
Immediately
Within 3 days
Within a week
When we get a chance
Temporary repair in place
Already repaired
No repair required
The damage is the responsibility of
*
Please Select
Client
Bluegum
Technician
What could we do differently in the future to avoid this happening in the future?
*
Was the damage due to negligence?
*
Please Select
Yes
No
Please upload photos of the damage
*
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Declaration: By submitting this form, I confirm that all information provided in this form is true and correct
*
I agree
I disagree
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