Oak Creek Plumbing On-line Service Call Form

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W.O.#
Office Use Only
Customer Service Rep
Technician Email
Appointment Confirmation
Office Use Only

Fill out this form to receive your $25 coupon off of your plumbing work. Not valid with existing or previous completed work.

(Please continue to fill out this form to help expedite the call)
Are you one of our Ultimate Service Agreement Holders (priority service at discount value pricing)*

YesNoNot SureHad one but it is expiredHad one but not sure if it is expiredWhat are you talking about? Give me more information.Other
Do you have any questions or would you like us to provide more information regarding the benefits of our Ultimate Service Agreements
How did you hear about us? (Select all that apply)*

RepeatReferral (Please list the person who referred you to us in the misc information box below)Yellow PagesRadioInternet SearchKohler ServicesValPak MailerPost CardOther
Misc Information
Property Owner (Final Decision Maker)*

First NameLast Name
Property Owner Email*
example@example.com
Alternate Email
example@example.com
Property Owner Best Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Is there any additional information you feel we should know about the property ownership such as payment responsibility and/or accessibility of the property?
Address where work is to be performed.*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you live at this property

YesNo
Any additional information you feel we should know about the property location.
Property Owner Address if different than work performed address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Any additional information you feel we may need to know about the property owner.
Ultimate Savings Agreement Minimum site visit charge based on the preferred time you would like us to be on the job-site. Cost of the repair will be quoted before work is performed and added to price below. (Service Agreement Holders will get special discounts off pricing below as well as the work provided.)*

Additional $20 discount. Any time Monday thru Friday between 8am and 4pm. I have nothing better to do or my schedule is pretty open. (we'll give you a call approx 30 minutes ahead of time. If your not available, no worries we'll keep you in the schedule for the next time we're in the area) DO NOT SELECT THIS SERVICE LEVEL IF YOU ARE HAVING AN EMERGENCY SITUATIONNO CHARGE Pick a day Monday thru Friday that you would be available between 8am and 4pm. (Please select day below)$20.00 Mornings Monday thru Friday (between 8-12) (Please select day below)$20.00 Mid Morning/Day Monday thru Friday (between 10-2) (Please select day below)$20.00 Afternoon Monday thru Friday (between 12-4) (Please select day below)$87.50 Due to my schedule or an emergency situation, I need an exact time between the hours of 8am and 4pm (with-in an hour) Monday thru Friday of when the technician will be on the job-site. (Please select day and time below)$137.50 (between 4pm to 10pm and 6am to 8am) (Please select day below)$187.50 (between 10pm and 6am and anytime Sunday or Holidays) (Please select day below)
Minimum site visit charge based on the preferred time you would like us to be on the job-site. Cost of the repair will be quoted before work is performed and added to price below. (Service Agreement Holders will get special discounts off pricing below as well as the work provided.)*

$39.00 Any time Monday thru Friday between 8am and 4pm. I have nothing better to do or my schedule is pretty open. (we'll give you a call approx 30 minutes ahead of time. If your not available, no worries we'll keep you in the schedule for the next time we're in the area) DO NOT SELECT THIS SERVICE LEVEL IF YOU ARE HAVING AN EMERGENCY SITUATION$59.00 Pick a day Monday thru Friday that you would be available between 8am and 4pm. (Please select day below)$79.00 Mornings Monday thru Friday (between 8-12) (Please select day below)$79.00 Mid Morning/Day Monday thru Friday (between 10-2) (Please select day below)$79.00 Afternoon Monday thru Friday (between 12-4) (Please select day below)$175.00 Due to my schedule or an emergency situation, I need an exact time between the hours of 8am and 4pm (with-in an hour) Monday thru Friday of when the technician will be on the job-site. (Please select day and time below)$275.00 (between 4pm to 10pm and 6am to 8am) (Please select day below)$375.00 (between 10pm and 6am and anytime Sunday or Holidays) (Please select day below)
Preferred Date you would need this work to be completed by. (Leave blank if no urgency)

MonthDayYear
We will make every effort to accommodate this request. We will keep you posted with any changes or issues
Preferred Date for work to be done*

MonthDayYear
We will make every effort to accommodate this request. We will keep you posted with any changes or issues
Preferred Date for work to be done M-F*

MonthDayYear
Date
If you selected $135.00 site visit charge please indicate preferred time between 8am and 4pm to be on the job site.*

:HourMinutesAM/PM Option
1. Preferred time to be on the job site.

Between 4pm and 10pmBetween 6am and 8am
2. Preferred time to be on the job site.

Between 10pm and 6 amSunday or a Holiday
Any additional information you feel we may need to know about preferred time on the job-site
How much time would you need to know that a Technician is on his way.*

No confirmation of time is needed. I'm home most of the time. Just give me a call when your on your way.I would need at least 1/2 hour notice to make the proper arrangementsI would need at least 1 hour notice to make the proper arrangementsI would need at least 2 hour notice to make the proper arrangementsI would need at least a days notice to make the proper arrangementsI would need more than a days notice to make the proper arrangementsOther
Best phone number to call if different than above to make the proper arrangements.

Area CodePhone Number
Can we text you to this number?

YesNo
Any additional information you feel we may need to know about informing you the technician is on the way
Preferred Method of Payment. All work is to be paid at substantial completion. Larger Project may require a down payment. (check all that may apply)*

CashCheckCredit/Debit CardWells Fargo FinancingNot sure, depends on how much the final investment will be.Other
Any additional information you feel we may need to know about Preferred Method of Payment
What door should we come to for access into the property
Where is the best place to park or any parking instructions.
Main Issue(s) (check all that apply)

Water Pipe LeakingDrain Pipe LeakingDrain Backing Up/CloggedSewer Line Backing Up/CloggedWater Heater Issue/replacementToilet IssueKitchen Sink IssueBathroom Sink IssueTub/Shower IssueOther
Heater Situation

Replace ExistingAdd to ExistingMove Heater to different locationEliminate Heater and cap off as neededNeed water heater repaired if possibleOther
Misc Information
Type of Water Heater you have now (check all that apply)

Natural GasPower VentElectricTanklessNot SureOther
Manufacture of existing water heater

Not SureBradford WhiteAO SmithStateRheemRichmanGEAmericanOther
Heater Model Number (no worries if you do not have)
Heater Serial Number (no worries if you do not have)
Do you have a water softener?

YesNoNot SureOther
Do you have a whole house carbon filter

YesNoNot SureOther
Is your water heater under manufactures warranty?

YesNoNot SureNot sure, have the tech check when on site.Other
Approx Age of Water Heater

Under 6 years old (Typical Manufacture Tank Failure warranty)7 to Ten years old years old (Upgraded Warranty Option)11 years or older (Typically outside of manufactures warranty)Not sure how old this heater isOther
Water Heater Status (check all that apply)

Tank is leakingNot HeatingNot enough hot waterSmelly WaterUse to be smelly but not anymoreJust getting old and want a new oneWant a more efficient heaterMoney is no object I just want the latest and greatest that is availableOther
Misc Information
Sense of Urgency

Creating Structural or Water DamageI NEED HOT WATER ASAP!!!I can handle it for a bit but the sooner the better.No rush I just want to upgrade or replace what I haveOther
Water Heater Removal (check all that apply)

I will drain existing water heaterI will need you to drain existing water heaterI will remove existing water heater from premise once its disconnectedI will need you to remove existing water heater from premiseNot sure, we'll figure this out once the tech is on site.Other
Water Heater Location (check all that apply)

BasementFirst floorSecond FloorThird FloorCrawl SpaceUnder Kitchen cabinetClosetNot sureOther
How accessible is the Water Heater (pathway to remove existing heater)

Clear pathway with no stairsClear pathway with one set of stairsClear pathway with turning stairsLimited accessibility (may have to move items to remove heater)Extreme limited accessibility (not sure how your going to get this in or out)Not Sure (tech will assess once on site)Other
Location of nearest floor drain

Within 25 feet of heaterOver 26 feet awayNot sure where the floor drain is.The floor drain is not accessibleNot sure how your going to drain the heaterNo worries I'll have the heater drained for you.Other
Type of Water Heater you would like installed

Not sure, You're the expert, I'll go with what you recommend30 gal gas40 gal gas50 gal gas75 gal gasPower VentTankless Water Heater30 gal electric40 gal electric50 gal electricHigh Efficiency Heater (may cost more but will save in operating costs)Upgraded warranties (gives you peace of mind)Other
Preferred Manufacture of Replacement Water Heater (check all that apply)

Not sure, You're the expert, I'll go with what you recommendBradford WhiteAO SmithRheemHTPI will provide my own water heater.I will make sure the water heater is deliveredI need you to make arrangements to have the water heater deliveredOther
Misc Infromation
Optional Water Heater Accessories (Check what you may be interested in)

Hot Water Circulating System (so you don't have to wait for the hot water at any faucet)Thermostatic Tempering Valve (Heater acts 50% bigger. EX: 50 gal heater will operate like a 75 gal heater)Anti Scale Inhibitor ( Heater will operate more efficient and extend water heater life)Auto Emergency Shut Off System (will sense if heater is leaking and will automatically shut off water valve to prevent any flooding)10 year parts and labor heater warrantyUpgraded drain valve to help in assisting flushing of the tank maintenanceUpgraded power anode rod (extends water heater life and eliminates smelly hot waterI may be interested in some of these. Please have the tech go over them with me when he is on site.Other
Any additional information you feel we may need to know before we enter the property. (pets, white carpeting, door bell is out, etc...)
How or what can we help you. What is the main issue*
Please type a brief description of what is going on
Upload pictures or documents that you feel we may need to see.

Browse Files

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How long has this issue been going on?*

Just noticed itA day or soA week or soA month or soA long timeHave no ideaOther
Any information you feel we may need to know on how long this issue has been going on.
Is this causing major damage?*

Yes, I need someone NOW to prevent further damageYes, but I can handle it for a bitNot sure, but I need someone soon to check it out to let me know how bad it might be.No damage is occurring but its just a pain having this issue.No damage, I just want to upgrade or change what I have.Other
Is there any additional information you feel we may need to know in order to best help you.
Is there anything you feel we may need to know or anyone we may need to contact if we would need to shut off or isolate the water?
At Oak Creek Plumbing we are not only in eliminating the issue (symptoms) we want to make sure we also give you the different options of eliminating what may be causing the problem so you won't have to worry about it for a very long time if ever again.Your property has a complete all encompassing integrated water, drain and vent piping and plumbing fixture system. Thats why on every visit we do an on-site plumbing inspection or we like to call it a "Plumbing Physical". We'll give you a report with our findings on items that may need attention whether it be immediate, very soon or down the road. Also we'll be happy to perform any small adjustments (tighten toilet seats, check faucet aerators, tighten valve handles and more) at no additional charge to you.
Are there any other plumbing issues, upgrades or changes you would like us to take a look at or discuss while we are on premise?
Approximately how old is the property

Less than 30 years old30 to 50 years old50 to 75 years oldOver 75 years oldI have no idea how old the property isOther
Anything you feel we may need to know about the age of the property
How long have you lived at this property?

Less than a year1 to 5 years5 to 20 yearsSeems like I have lived here forever. I've lost countThis is a investment property.Other
Anything you feel we may need to know about how long you have lived at this property?
Is there any special needs that you feel we may need to know about while working on your property?
Do you have any plans of moving out or selling this property?

Yes, with-in a yearYes, 1 to 5 yearsNot sure but we'll be here for at least 5 years if not longer.We do not plan on moving. They'll have to drag us out.Not sure what our plans areOther
Anything you feel we may need to know about future occupancy of this property?
Are there any future kitchen or bathroom remodeling or upgrading projects that you may be considering in the near future?*

Yes, please have someone contact me to make arrangements to have a consultant come out to take a look and give us some options and budgets.No, All is good and we want to live with what we have.Not sure. Have a consultant give us a call.Other
Anything you feel we may need to know about future remodeling or upgrading projects?
Any pictures or documents you would like us to see for future projects or upgrades.

Browse Files

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Thank you for your time. We look forward to serving you

Sincerely,

All of the team at Oak Creek Plumbing Kitchen & Bath
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Fill out this form to receive your $25 coupon off of your plumbing work. Not valid with existing or previous completed work.