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Tufts Mechanical work request
Pool company referral form
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* Indicates required question
Email
*
Your email
Date of request
*
MM
/
DD
/
YYYY
Requester's cell phone
Your answer
Customer Name
*
Your answer
Customer Address
*
Your answer
Customer Town
*
Your answer
customer phone
Your answer
customer Email (please so important)
Your answer
Equipment needing repair
*
gas heater
Electric heat pump
Automation system
salt generator
firepit
Other:
description of problem
*
Your answer
bill customer
*
Choose
yes
bill pool servicer
does customer need to be contacted prior to visit
Yes (could delay response)
No they are ok with you coming
Other:
Clear selection
Send me a copy of my responses.
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