Form templates / Home Services
Appliance Repair Request Form
An appliance repair request form should get you the model number. Without it you arrive without the part, and a second visit costs more than the first job was worth.
For cleaners, gardeners, plumbers, electricians and home-service businesses.
The model number decides whether you go once or twice
Appliance repair economics are simple: a job completed on the first visit is profitable and a job needing a return visit usually isn't. The difference is almost always whether you knew the model before you left.
So this template asks for make and model with a prompt about where to find the plate, plus the appliance age. That second answer matters too: a fourteen-year-old washing machine with a bearing fault is a replacement conversation, and it's better to have it before you charge a call-out.
Requests you can actually schedule
A name and "sometime next week" isn't a booking. What you need is when they can come, what they want, and how to reach them if the slot moves.
This template asks all three, so the diary entry is a copy-and-paste rather than a conversation.
Address, access and "is anyone home?"
The details that decide whether a visit is 40 minutes or two hours are all logistical: the postcode, the parking, how many rooms, whether there's a dog, who's letting you in.
Ask them once on a form and you can schedule properly, price honestly, and stop arriving at jobs that were described optimistically.
Give them options, not a blank box
Open questions get vague answers. Offering the services and the times you actually have makes the request usable, and quietly steers people towards the slots you want to fill.
One minute to make it your own
Every label, option and placeholder on this template is editable, and you can add whatever this template doesn't ask. Save to publish, share the link, and export the responses whenever you need them in a spreadsheet.
What this template asks
- Your name
- Email address
- Phone number
- Address and postcode
- What needs repairing?
- Make
- Model number
- Roughly how old is it?
- Is it still under warranty?
- What's it doing?
- Error code, if one is showing
- Which apply?
- How urgent?
- When are you in?
- Anything about access?
- I understand a call-out fee applies and will be charged even if the appliance can't be repaired
More Home Services forms
Questions
What if the customer can't find the model number?
The template tells them where to look - inside the door, on the back, behind the drawer - and keeps it optional. Make plus age plus a good fault description gets you most of the way.
Should I quote a call-out fee on the form?
Yes, and ask them to acknowledge it. It's the single biggest source of doorstep disputes in appliance repair.
Does this book the slot automatically?
No - it collects a request, and you confirm it. That's deliberate: real diaries have exceptions, and a form that promises a slot you can't honour costs more than one that asks.
Can I limit the options people can pick?
Yes. The service and time-of-day lists are yours to edit, so people can only choose from what you actually offer. You can also close the form when you're full.
Will I know straight away?
Yes, if you want to be. Turn on live notifications and every request is emailed to you the moment it arrives; otherwise collect them and read them in your dashboard.
Can I ask for a postcode and check it's in my area?
You can ask for it, and it's stored with the response - so you'll see immediately whether a job is in range. Automatic area checking isn't built in; a line in the form saying which areas you cover does the job.
Publish your appliance repair request form today
Start from this template and change anything you like. Free to begin.