PROPERTY MAINTENANCE CAFE CUSTOMER SERVICE REQUEST FORM
Please complete this form to request property maintenance or repair services. Our office will review your request and contact you to schedule a FREE estimate. Submitting this form does not guarantee same-day service or immediate availability.
Page 1 — Customer Information
First Name and Last Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Preferred Contact Method
*
Phone
Text Message
Email
Best Time to Contact
*
Morning
Afternoon
Evening
Anytime
I am a:
*
Homeowner
Landlord
Property Manager
Real Estate Investor
Tenant
Business Owner
Authorized Representative
Other
Page 2 — Property Information
Service Address
*
City
*
State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP Code
*
Property Type
*
Single Family Home
Townhome
Condo
Apartment
Rental Property
Commercial Property
Vacant Property
Other
Page 3 — Service Request
What service do you need?
*
Handyman Repairs
Plumbing
Electrical
HVAC
Painting
Drywall
Carpentry
Flooring
Tile
Roofing
Gutters
Pressure Washing
Lawn Care
Landscaping
Junk Removal
Fence Repair
Deck Repair
Window Repair
Door Repair
Appliance Installation
Garage Door Repair
General Maintenance
Cleaning Services
Other
Please describe the repairs or maintenance needed.
*
Upload Photos
Upload a File
Drag and drop files here
Choose a file
Cancel
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Page 4 — Scheduling
When would you like service?
*
ASAP
Within 3 Days
Within One Week
Flexible
Requesting Estimate Only
Is someone over 18 available to meet our technician?
*
Yes
No
How did you hear about us?
*
Please Select
Google
Facebook
Yelp
Referral
Returning Customer
Yard Sign
Other
Additional Comments
Agreement
*
I certify that the information provided is accurate.
I understand this is a request for service and not a guaranteed appointment.
I authorize Property Maintenance Cafe to contact me regarding my request.
REQUEST MY FREE ESTIMATE
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