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Repair Request Form

Does your equipment need repair? Fill out this form.

Time to complete

3 minutes

Eligibility

When your equipment needs repair, you are the best fit to fill out repair request form.

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Questions for Repair Request Form

1.

Request Date

The answer should be a date input.
2.

Name

The answer should be a text input.
3.

Phone Number

The answer should be a phone number.
4.

Email

The answer should be an email input.
5.

Address

The answer should be a text input.
6.

Street Address

The answer should be a text input.
7.

City

The answer should be a text input.
8.

State / Province

The answer should be a text input.
9.

Postal / Zip Code

The answer should be a number input.
10.

Equipment Information

The answer should be a text input.
11.

Upload photos of the equipment that needs repair

File needs to be uploaded.
12.

Was the equipment listed above been repaired for the same issue

The answer should be a single choice:
  1. Yes
  2. No
13.

Was the issue caused by accidental damage like water spill, equipment was dropped

The answer should be a single choice:
  1. Yes
  2. No
14.

Payment method

The answer should be a single choice:
  1. Cash
  2. Credit card
  3. Others
15.

Do you have any special instructions

The answer should be a text input.

Similar Ideas

  • Service Request Form
  • Maintenance Request Form
  • Repair Request Form
  • Equipment Request Form
  • Installation Request Form
  • Replacement Request Form
  • Return Request Form
  • Refund Request Form
  • Dispute Request Form

Here are some FAQs and additional information
on Repair Request Form

How do I submit a repair request?

You can submit a repair request by submitting a BlockSurvey form.

What happens after I submit a repair request?

Once you have submitted a repair request, the maintenance staff will be notified and will work on completing the repair as soon as possible.

How do I know if my repair has been completed?

You will be notified by email when your repair request is completed.

What do I do if I submitted a repair request but it was never completed?

If you submitted a repair request but it was never completed, you can contact the maintenance team.

What is considered an emergency repair?

Some examples of emergency repairs include: -No heat -No water -No electricity

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