Repair or service request form with photo and preferred visit times
A repair request is much easier to price with a photo and a clear description. This form asks for the customer's contact details, the address of the job, the type of work (plumbing, electrical, heating, carpentry, painting, roofing or other), what needs fixing, the urgency, a photo and the times that suit them for a visit.
Who it is for
- Plumbers, electricians, carpenters and painters
- Small repair and maintenance businesses
- Property managers who send contractors
When to use it
Put the link on your website, your van or your business card. A photo and a description let you decide whether you need to visit, what to bring and whether the job is urgent, before you drive anywhere.
What the form asks
Questions
- Full name · requiredShort text
- Email address · requiredEmail
- Phone numberPhone
- Address of the job · requiredShort text
- Type of work · requiredDropdown
- What needs fixing? · requiredLong text
- Urgency · requiredMultiple choice
- Photo (PNG or JPEG)Image upload
- Preferred times for a visitCheckboxes
Every question can be changed, removed or reordered before you publish.
The PDF your respondents receive
Each request is a PDF with the photo, the description and the preferred times, ready to become a job sheet. The customer gets a copy confirming what they asked for.
Questions people ask
- Does it give a price?
- No. It collects the request. You reply with an estimate, or use the quote template with totals to price the work.
- Is it right for emergencies?
- No form is. For a gas leak, flooding or similar, customers should phone you or the emergency services.
- Can I add more photos?
- This template has one photo field. Add more upload questions if you want several views.
Start from this template
Create an account, adapt the questions and the document to your business, then share the link. Your respondents get their PDF the moment they finish.