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Service Request Intake Form
Please answer the questions below so we may best serve you.
Today's Date
Name Please:
Email:
Enter your email address
Phone Number:
Enter your phone number
Preferred Communication Method:
Call
Text
E-Mail
Select which service your requesting:
Initial Inspection
Repair
Replacement
I don't know yet
Roof Type
Select Current Roof Type:
Metal
3 Tab Shingle (Flat)
Architectural shingles (3D)
Other
Urgency
Urgent
Non-Urgent
Description of Damage
Describe the roof damage in detail
Do You Have Visibile Damages?
Please select all that apply
Missing Shingles
Water Stains
Gutters hangning/ loose
Fallen Trees
Structual Damages (Siding/ Holes/ Cracks/ etc)
Other property damaged
Please Upload Any Supporting Pictures/ Documents
Choose file
or drop here
Are You Going Through Insurance?
Yes
No
Possibly
If yes, have you already filed a claim concerning this damage to your property?
Yes
No
Insurance Company:
Please leave blank if no
I agree to the terms and conditions.
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