Service Booking Form

Service Required *

Name *

First

Last

Phone number *

Email *

Address *

CBD and suburbs of Perth, Western Australia only

Preferred Day and Timeslot *

Please select your preferred days and timeslots for a technician visit. You can select more than one. Timeslots cannot be altered or shortened.

Site Contact *

Alternate Site Contact Name *

First

Last

Alternate Site Contact Phone *

Text/Call on Approach *

Comment or Message

Coronavirus (COVID-19) Declaration *

I confirm that no one inside is currently unwell and I have no reason to suspect that I or anyone inside has been exposed to someone with, or suspected to have, Coronavirus (COVID-19)
I confirm that I am not in self-isolation due to having had contact with someone with suspected or diagnosed Coronavirus (COVID-19)
I confirm that I am not in self-isolation due to having recently arrived from interstate or overseas

Please check all boxes above. If you are not able to confirm the above, please contact us to discuss possible alternative arrangements.

Payment Terms

Payment Terms Agreement *

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