Work Request Form

Guaranteed Plumbing Solutions Work Request Form
Company (optional)
Name

First Name Last Name
E-mail
Phone

Area Code Phone Number
Mobile

Address

Street Address
Street Address Line 2
Suburb	State
Post Code	Country

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.

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

Are you renting through a real estate agency? *

Yes No
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?

Yes No
Problem area

Hot Water Blockage Taps, spouts and other outlets Gas cooktop Toilet Burst Pipe

Burst Pipes
Burst Pipes
Is it in the house or ground?

House Ground
Is it an Internal wall or external?

Internal External
Is it within 1 meter of the water meter?

Yes No
Is there a puddle?

Yes No
Please provide any relevant information regarding the burst pipe.

Submission
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

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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