Schedule Appointment
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
How did you hear about us?
*
Please Select
Web search
Referral
Radio Mention
Community Event Sponsor
Print Ad
TV Commercial
Online Ad
Other
Are you a current customer?
*
Yes
No
Is this a Propane or Electric appointment?
*
Propane
Electric
Other
Is this a service or sales appointment?
Service
Sales
Which of our products are you interested in getting serviced? (Select all that apply)
Electrical Repair Service (please note service needed in comment box)
Boilers - Pre-season cleanings
Furnace - Pre-season cleanings
Gas logs - Pre-season cleanings
Pool heater - Pre-season cleanings
Space heater - Pre-season cleanings
Generator tune-up - Preventive Maintenance
Water heater - Preventive Maintenance
Other
Which of our products are you interested learning more about? (Select all that apply)
Electrical Upgrade/Installation/Wiring (please note service needed in comment box)
Boiler
Cooking stove
Furnaces
Gas logs
Generators
Heating stove
Patio Equipment
Pool heaters
Remote tank monitor
Space heaters
Water heaters
Other
Preferred Day for Appointment
Please Select
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preferred Time for Appointment
Before 12 noon
After 12 noon
Preferred Time for Sales Appointment
Between 8am - 12pm
Between 12pm-3pm
Between 3pm-6pm
Please share more details about your request
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