Reporting a new repair

Please complete all fields marked *

Your Contact Details

Title

Title (if other)

First Name *

Surname / Family Name *

Address for Posting *

Post Code *

Telephone (Home)

Telephone (Work)

Mobile Telephone

e-Mail Address *

Reporting for someone else

If you are reporting this repair for someone else please use the spaces below to give their contact details

Title

Title (if other)

First Name

Surname / Family Name

Address for Posting

Post Code

Telephone (Home)

Telephone (Work)

Mobile Telephone

e-Mail Address

Repair Details

Where is the item that needs repairing located? *

Please use this section to give as much information about the location of the repair, and as detailed a description of the fault as possible: size, dimensions, how big an area is affected, has it got worse since you first noticed it, etc.

When did you first notice the item needed repairing? *

Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    Month January February March April May June July August September October November December    Year 2012 2013 2014 2015 2016

When you would prefer an appointment?
Morning appointments are from 8am to 1pm and afternoon appointments are from 12pm to 5pm. If you do not have a preference, please leave blank and also note that we will contact you to confirm the appointment.

Monday

Tuesday

Wednesday

Thursday

Friday

If you have any special requirements or needs relating to this repair, please give details

Do you have any specific access arrangements about which we should be aware? (i.e. impaired hearing, intercom or doorbell not working)

How would you prefer us to contact you about this issue? *