Work Request Form

Guaranteed Plumbing Solutions Work Request Form
Company (optional)
Name

First NameLast Name
E-mail
Phone

Area CodePhone Number
Mobile
Format: 0000000000.
Address

Street Address

Street Address Line 2

SuburbState

Post Code
Availability

Please select hours you will be available. Keep in mind we service a large number of customers and cannot guarantee availability at specific times. The more you times you select, the easier it will be to schedule. Either select "Any time" or individual times for each day.

Rows	Any time	8am	9am	10am	11am	2pm	3pm
Mon
Tue
Wed
Thu
Fri

Are you renting through a real estate agency?*

YesNo
Please Specify
Other Real Esate
Do you give permission for us to collect keys from the real estate and do the job at a time that suits us?

YesNo
Problem area

Hot WaterBlockageTaps, spouts and other outletsGas cooktopToiletBurst Pipe
- Hot Water Systems
- Is there water flowing from the hot Tap?
  
  YesNo
- Is there water flowing from the cold taps?
  
  YesNo
- Is your hot water system leaking?
  
  YesNo
- Is it heating water at all?
  
  YesNo
- Is it leaking from a pipe or the cylinder?
  
  PipeCylinder
- The hot water system will most likely need to be replaced.
- What size?
  
  125L250L315LDon't know
- Please specify measurements, rough height and width.
- Where is the unit located?
  
  InsideInside under the houseOutside
- Is it on the ground or on a shelf?
  
  GroundShelf
- Is the unit easily accessible with space around it?
  
  YesNo
- Blockage
- Is it Stormwater or Sewer?
  
  StormwaterSewer
- Stormwater can be hard to diagnose, please allow a few hours in your availability.
- Is the whole house affected?
  
  YesNo
- Do you have a septic system?
  
  YesNo
- Does the septic have a pump on it?
  
  YesNo
- Is the house on stumps or slab?
  
  StumpsSlab
- Do you have PVC access caps near the house?
  
  YesNo
- Burst Pipes
- Is it in the house or ground?
  
  HouseGround
- Is it an Internal wall or external?
  
  InternalExternal
- Is it within 1 meter of the water meter?
  
  YesNo
- Is there a puddle?
  
  YesNo
- Please provide any relevant information regarding the burst pipe.
- Gas Cooktops
- Replacement or repair?
  
  ReplacementRepair
- Is it replacing an exsiting gas cooktop?
  
  YesNo
- Do you have an existing gas system?
  
  YesNo
- Is any part of the gas system within 3 meters of the cooker?
  
  YesNo
- Please specify approximate distance
- Will the new cooktop be against an external wall?
  
  YesNo
- Are there any doors, windows or drains within 1 meter of where the gas bottles will be located?
  
  YesNo
- Taps, Spouts and Other Outlets
- Problem outlets
  
  Shower RoseShower TapsBathroom TapsLaundry TapsKitchen TapsGarden TapsOther
- Please Specify other
- Are they mixer taps or separate hot and cold?
  
  MixerSeparate
- Is the outlet spout dripping/running or leaking from the handle?
  
  Dripping/runningLeaking from the handleBoth
- Toilets
- What is wrong with the toilet?
  
  LeakingNeeds ReplacementNot working
- Where is it leaking from?
  
  Cistern into the bowlCistern onto the floorBack/bottom of the toilet onto the floorIsolation tap
- Is the cistern porcelain or plastic?
  
  PorcelainPlastic
- Does the toilet waste go into the floor or wall?
  
  FloorWall
- Please provide details
- Please provide any additional information that may be relevant
- Please attach any relevant photos. The model plate and valves for hot water systems, any leaking outlets, taps, spouts etc.. This will help us organise the correct equipment and get the job done faster for you. Please be patient uploading photos, some devices can take a while.
- Upload a File
  
  Cancelof
- *
  
  I agree to Guaranteed Plumbing Solutions Terms & Conditions.
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Guaranteed Plumbing Solutions Work Request Form

Availability

Hot Water Systems

Blockage

Burst Pipes

Gas Cooktops

Taps, Spouts and Other Outlets

Toilets