New/Add on Customer Form

Thank you for partnering with Oasis Preferred Maintenance! Please provide the information below so we can set up your new service

Please complete the form below and select any new services you’re interested in having installed for your business. Our technicians are ready to swing back by to add a water filtration system to enhance your customers’ experience, or to enroll additional ice machine equipment into a Preventive Maintenance (PM) membership where applicable. We appreciate your support!
Business Name*
Business Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Hours of Access/Site Notes*
Make, Model #, Serial # of Equipment*
How Did You Hear About Us?*
Please Specify*
If you received a Flyer. Please enter the Techs name that appears below the QR code or type in web submission if online*
Business Phone Number*
Please enter a valid phone number.
Business Email Address*
example@example.com
Primary Contact Name*

First NameLast Name
Billing Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Which services are you interested in?

VOC Water Filter SystemIce Machine Cleaning OnlyIce Machine Membership PlanIce Machine LeaseIce Machine Service Call
What Size Ice Machine & Storage Bin would you like us to quote?*

Thank you for partnering with Oasis Preferred Maintenance! Please provide the information below so we can set up your new service