Service Call Request
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Service Call Request
Type of Request
Please select
Measure
Install
Repair
Customer Information
Date
Full Name
Address
Home Phone
Cell Phone
Work Phone
Payment Instructions
Client Pays Installer
Please select
Yes
No
DHB Pays Installer
Please select
Yes
No
Why?
Installer Pays
Please select
Yes
No
Why?
Room Locations to Be Measured
Living Room
Dining Room
Family Room
Kitchen
Powder Room
Office
Master Bedroom
Bedroom 1
Bedroom 2
Bedroom 3
Bedroom 4
Solarium
Stair Well
Laundry
Basement
Other
Other (If Applicable) or More Information
Blinds
Manufacturer
Elite
Graber
Maxxmar
Blind Type(s) & Number of Windows
Wood
Please select
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Faux Wood
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Vertical / Panel
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Cassette Roller
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Roman
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Cellular
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Woven Shade
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Shade
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Extra Blind Information
Shutters
Manufacturer
Elite
Graber
Maxxmar
Shutter Type(s) & Number of Windows
Polysatin
Please select
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Faux Wood
Please select
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Polysilk
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Wood Alloy
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Wood
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Extra Shutter Information
Service Details
Over 30km Radius?
Please select
Yes
No
How Many Kilometers over 30? (If Applicable)
Templates Required? (i.e. Arches, Angled, Skylights)
Please select
Yes
No
How Many Windows?
Please select
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Remove Existing Hardware & Window Coverings?
Please select
Yes
No
How Many Windows?
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Tall Ladder Over 10 Feet (Required For Detail and Install)
Please select
Yes
No
How Many Windows?
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Garbage or Blind Disposals
Please select
Yes
No
Condo / Apartment
Please select
Yes
No
House / Town House
Please select
Yes
No
Office Commercial
Please select
Yes
No
Request Date
Confirmed Date / Time
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Service Call Request
