Appliance Service of Houston BBB Business Review
                                                          Notice To Customers!
Prior to completing this form, we suggest that you please review our "Service Exclusions" page to ensure that we provide the service that you are seeking.
Appliance Service of Houston's 
Service Appointment Request Form
                (Schedule Service)
Date:
Referred By:
Last Name:
Telephone:
Email:
Customer Data
Brand:
Appliance:
Model #:
Serial #:
Age:
Issue/Problem:
Comments (e.g.:  stacked unit, upstairs, rental property, etc.):
Service Appointment Data*
Requested Date:
Requested Time:
AM
PM
                                       Service Discounts
                   (excludes diagnosis/estimate labor)
  (Please check applicable customer category(ies) below)
Customer ​Definitions 
New Customer:  A customer that has never used our company for appliance service.
Loyal Customer:  A customer that has used our company for appliance service in the past.
Senior Citizen Customer:  A customer or someone that resides in the customer's home that is 65 years of age or older.
​Discount Terms and Conditions
Customer must request applicable discount(s) prior to actual repair/service.  Discounts apply to repair labor, not diagnosis/estimate labor.  Discounts are applied to each appliance serviced, with a maximum of 35% off repair labor (e.g.: Loyal Customer and Senior Citizen Customer = 35% maximum discount).  The customer's request for discount(s) will be satisfied by checking the appropriate box(es) above.

Allow up to 24 hours for confirmation and scheduling of your request;  Service request must be
   submitted to our company's email address (click on "submit" button below) for scheduling             
   and confirmation;  Appointments are scheduled no more than one week in advance.  We 
   schedule appointments in order of receipt from customers.  Please note that we must confirm the 
   appointment.  Your "request" is not a confirmation!
                   Open 8 AM - 6 PM 
                   Monday - Saturday            

         Monday - Saturday Appointments
              (By exact time and date)

                1st Appointment:    10 AM

                Last Appointment:    4 PM

 Closed Sundays and National Holidays


Address:
(complete address)
Gate Code:
Appliance Data
New Customer (10% off repair labor)
Loyal Customer (15% off repair labor)
Senior Citizen Customer (20% off repair labor)