Appliance Repair - Request Service - Small Home Appliance

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Brand*
Warranty Status
Appliance Type*
Postal Code*
Problem Description (as you see it)*
Photos of Problem
Drop files here or

Accepted file types: jpg, jpeg, gif, png.
Model #*
Serial #*
Photo of Model and Serial Tag
Accepted file types: jpg, jpeg, gif, png.
Other #
Some appliances with have an additional number, sometimes called a "revision", "production", "manufacturing", or "index" number. If so, these will often be necessary to acquire the correct parts.
Dealer
Date of Purchase*
Dealer’s Purchase Invoice #*

Your Name*
Email*
Primary Phone Number*
Secondary Phone Number
Service Location*
Street Address Address Line 2 City Province Postal Code
Are you the owner/paying party?
- Yes
- No
Billing Name*
Billing Phone Number*
Billing Address*
Street Address Address Line 2 City Province Postal Code
Preferred Date

Please note: this date is not confirmed until discussed with the dispatchers.
Alternative Date

Please note: this date is not confirmed until discussed with the dispatchers.
Time of Day*
Will you be on-site to meet the technician?
- Yes
- No
Do you have a preferred technician from prior service?
Payment Method*
For non-warranty service, our technician will need to collect while on site unless you are a business with an account setup.
PO#:*
Special Instructions
Are there are special access instructions that the technician needs to know? (ex: access codes, directions, etc)
Special Instructions Attachment
Accepted file types: jpg, gif, png, pdf.
Comments
This field is for validation purposes and should be left unchanged.

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