Service Request Form | Repairs & Services

Service Request Form

We have made it easy for you to place a service/repair call. Please fill out the on-line Service Request Form and we will respond to you within 24 hours. It may be necessary for us to call you prior to scheduling the service/repair ticket.

Our organization is built on service. If you haven’t utilized our excellent service before, upon receiving your request, we will call you and arrange for proper payment terms. You may wish to obtain open account credit. This can be achieved by submitting a credit application. Please note that we do take most major credit cards.

We thank you for considering our company and look forward to Earning Your Business!

= Required
Contact Information
Are you a	Please select if you are Current or New Customer
Business Name	Please enter your Business Name
Contact First Name	Please enter your First Name
Contact Last Name	Please enter your Last Name
Contact Telephone	Please enter your Telephone
Contact Email	Please enter your Email Address

Bill To Address 1	Please enter your Primary Billing Address
Bill To Address 2	Please enter your Secondary Billing Address
Bill To City	Bill To City field is Required
Bill To State	Bill To State filed is Required
Bill To Zip	Bill To Zip filed is Required
Facility Information
Facility Name	Please enter a Facility Name
Facility Address 1	Facility Address field is required
Facility Address 2	Invalid Input
City	City field is Required
State	Please select a State
Zip	Zip field is Required
Product Servicing Information
Model of Product(s) to Service:
Washer:	Invalid Input
Dyer:	Invalid Input
Ironer:	Invalid Input
Other:	Invalid Input
Product Voltage	Product Voltage field is Required
Heat Type	Heat Type field is Required
Describe Symptom / Problem	Describe Symptom/Problem field is Required
Is the product under warranty?	Please Select if the Product is under Warranty
Purchase from Super Laundry?	Please Select if Purchase from Super Laundry
If yes - date of purchase:	Invalid Input
If Yes - Serial Number	Invalid Input
For weekends and evenings, do you want emergency service:	Please Select if do you want emergency service for weekends and evenings
(Please note-for emergency services please call appropriate location and follow Prompts. Emergency service will be billed at 1.5 times the normal labor rate)