WE MAKE HOUSE CALLS!
Serving 22 Counties in Middle Tennessee
Name: First Last
Address: Your Full Address Make Sure to include apt #'s and other information.
City: Your City
State: Your State
Zip: Zip Code
Phone: Area Code-Prefix-Number Example 931-555-1111.
Cell: Your Cell Phone Number in case we cannot reach you at your home number. Enter NONE if you do not have one.
Email: Enter your email address (you@myisp.com) must be a valid email address without ().
Make: Enter the brand name of the unit to be repaired (RCA, JVC, Sony, Whirlpool, etc.).
Model: The Model number is usually found on the back of the television or inside the door on appliances.
Serial: The Serial number is usually found on the back of the television or inside the door on appliances.
Type: Use the drop down box to tell us what kind of unit it is. Choose OTHER if yours is not listed.
0023550: This box cannot be changed skip it.
Problem: Enter a short description of the problem with the unit.
Send: Submit this Form.
Clear: Clear this Form.