Request Service

Your Contact Information

Full Name * Please enter your full name.

Phone Number * Please enter a valid phone number.

Email Address * Please enter a valid email address.

Service Address * Please enter your service address.

Appliance & Issue

Describe the Issue * Please describe the issue.

Appliance Brand (optional)

Model Number (optional — check inside door or back panel)

Preferred Contact Method *

📞 Phone Call

💬 Text Message

✉️ Email

Please select a preferred contact method.

⚠️ Service Fee Notice

Appliance Solutions LLC charges a $100 service fee. This fee will also provide a 30-day free diagnostic for any appliance in the home should any other problems arise. This fee will be due when the technician arrives — not when this form is submitted.

✅

Request Submitted!

Thank you! Your service request has been received.

A member of our team will reach out to you via your preferred contact method to confirm your appointment.

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Service Fee Acknowledgment

Request Submitted!