Appointment Request Form

WOOTEN APPLIANCE Appointment or Service Request

~~We do NOT service Asko, Fisher Pakel, Meile, Summit, or Thermador~~
****Fridge or freezer must be plugged in & running at appointment in order to diagnose problem****
Property owner name

First NameLast Name
Cell Phone

Area CodePhone Number
Home Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Email
Are you a previous customer?
Do you reside at the property where the appliance is located?
Tenant name if applicable

First NameLast Name
Tenant contact number

Area CodePhone Number
Tenant email
Service Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which county in the US is your city located?
How were you referred?
What day/days work best for you? We will do our best to schedule for your preferred day. A diagnostic service fee applies to all initial visits.
Please note first appliance type and problem or question with as many details as possible.
1st Appliance Brand
Please note second appliance type and problem or question with as many details as possible.
2nd Appliance Brand
Please note third appliance type and problem or question with as many details as possible.
3rd Appliance Brand
Type "NO COUPON" OR note if using ANGIES LIST COUPON & include AMOUT THE COUPON IS FOR ($20 new customer, $139 or $159 Large Appliance Repair)
Should be Empty:

WOOTEN APPLIANCE Appointment or Service Request