• Texwin Contractors Customer Intake

    Customer intake form for service requests, callback scheduling, and internal transfer notes. Preserve the source form’s labels, grouping, and checkbox-style options as closely as possible.

  • Customer Contact & Property Info

  • Format: (000) 000-0000.
  • Property Type*
  • Preferred Contact Method*
  • Best Time to Contact

  • General Service Request

  • Primary Service*
  • Urgency*

  • HVAC Service Details

  • HVAC Service*
  • HVAC Problem / Request*
  • Approximate System Age
  • Has Another Technician Worked on It Recently?
  • HVAC Photos Available?

  • Electrical Service Details

  • Electrical Service*
  • Electrical Problem / Request*
  • Immediate Safety Concern?*
  • Burning Smell / Smoke / Sparks Present?*
  • Electrical Photos Available?

  • Plumbing Service Details

  • Plumbing Service*
  • Problem Location (Plumbing)*
  • Plumbing Problem / Request*
  • Is Water Actively Leaking?*
  • Can the Water Supply Be Shut Off?*
  • Visible Water Damage?*
  • Plumbing Photos / Video Available?*

  • Painting Service Details

  • Painting Service*
  • Areas to Be Painted*
  • Surface Condition*
  • Surface Preparation Needed?*
  • Paint Color Selected?*
  • Who Provides Paint?*
  • Painting Photos Available?*

  • Uploads, Scheduling & Transfer Notes

  • Customer Can Provide Photos / Videos?
  • Documents Available?
  • Preferred Service / Callback Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date / Time of Call
     - -
    2 digit month, 2 digit day, 4 digit year
  • Lead Source
  • Priority
  • Transferred to Edwin?
  • Should be Empty: