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Fill out the form below
Personal Information
First Name
Last Name
Phone
Email
Unit Information
Street Address
Street Address 2
City
State / Region
Zip Code
Additional Information
Please be as detailed as possible when referring to the item needing repair.
Problem / Issue
Select Problem / Issue
A/C
Washer
Dryer
Dishwasher
Stove
Range
Microwave
Refrigerator
Garbage Disposal
Electric
Lighting
Plumbing
Pest Control
Other
Location
Select Location
Kitchen
Living Room
Family Room
Office
Master Bedroom
Master Bathroom
2nd Bedroom
2nd Bathroom
3rd Bedroom
3rd Bathroom
Foyer
Patio
Pool
Other
When did the problem start?
When can we schedule an appointment?
When can we schedule an appointment?
Monday
Tuesday
Wednesday
Thursday
Friday
Time Frame
Time Frame
9:00 am to 12:00 pm
12:00 pm to 3:00 pm
3:00 pm to 6:00pm
Other
Pet on site?
Pet on site?
yes
no
If pet on site, please make appropriate arrangements in order to facilitate the repair without interference.
File Upload
File Upload
I give permission to HGRE and its' associates to enter the premises in my absence.
I give permission to HGRE and its' associates to enter the premises in my absence.
Yes
No
Agreement
I acknowledged that I understand that I will be responsible for the repair if the item to be repaired is due to my negligence, and/or if the item needing repair it is not over $100.00.
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