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Service Type Requested
*
Select The Type of Service The Customer Requires
Dealer
Repair ticket number #
*
Select warranty company
*
Samsung Warranty
Electrolux Warranty
LG Warranty
Dacor Warranty
Frigidaire Warranty
Miele Warranty
Maytag Warranty
Whirlpool Warranty
Bosch Warranty
Midea Warranty
Other
Billing information
*
Billing information
*
Appliance owner information
*
No spaces allowed in city name, use space or comma to advance to postal code.
Model #
*
Serial #
*
Product Type
*
Select product
Built in Oven
Dishwasher
Dryer
Ice Maker
Microwave
Range Hood
Refrigerator
Stove
Washer
Product Make
*
Choose one
SAMSUNG
ELECTROLUX
FRIGIDAIRE
ADMIRAL
AMANA
BOSCH
CROSSLEY
DACOR
DANBY
GE/GENERAL ELECTRIC
HAIER
HOTPOINT
INGLIS
JENNAIR
KENMORE
KITCHEN AID
LG ELECTRONICS
MAGIC CHEF
MAYTAG
MOFFAT
ROPER
WESTINGHOUSE
WHIRLPOOL
WOODS
Take or upload a picture of your appliance
*
×
Drag and drop files here or
Browse
Is this a build in refrigerator?
*
Yes
No
Is the appliance gas?
*
Yes
No
Sorry we are not licensed to service gas appliances. The app cannot be completed. No information has been submitted and you may now close your browser window.
Is the appliance a stacked washer dryer that you are not able to unstack prior to our visit?
*
Yes they are stacked
No they are not stacked
What is the condition of the ice maker?
*
Frozen and unable to remove
Broken
None of the above
Is the refrigerator cooling properly?
*
Yes
No
Is the refrigerator compartment cooling?
*
Yes
No
Is the freezer compartment cooling?
*
Yes
No
Are both compatments warm?
*
Yes
No
Take or upload three (3) pictures of the area around the washer dryer stack.
*
×
Drag and drop files here or
Browse
Do you require the technician to mask?
*
Mask Required
No Mask Required
Please remember all photos must be legible.
Acceptable file formats are .jpg, .png, .gif, .jpeg. The problem box also accepts .mp4.
When filling this form in on a mobile device clicking Browse will also allow you to take a picture with the camera.
Take a picture or upload your model and serial number for confirmation tag.
*
×
Drag and drop files here or
Browse
Description/Request
*
Take or upload three (3) pictures of the problem, broken or detached parts.
*
×
Drag and drop files here or
Browse
Is your appliance showing an error code?
*
Yes
No
Take or upload a picture of any error codes showing on the appliance. Error code must be clearly visible in the picture.
*
×
Drag and drop files here or
Browse
Can you supply a short video of the problem, broken or detached parts?
*
Yes
No
Take or upload a short video of the problem, broken or detached parts.
*
×
Drag and drop files here or
Browse
Upload your bill of sale
*
×
Drag and drop files here or
Browse
Purchase date
*
Delivery date
*
Preferred method of communication
*
Choose one
Text (Most Preferred)
EMail (Preferred)
Verbal (slower turn around and no progress updates)
How did you hear about us?
*
Select one
Bad Boy
Bing
Canadian Appliance
Canadian Time
Frigidaire
Google
HomeStar
Home Depot
Medea
Paddy's Market
Returning Customer
Rona
Samsung
Word of Mouth
This form was filled in by:
*
Choose one
Office
Call Centre
Appliance Owner
Click here to complete the app and send the information to the repair centre. Incomplete or illegible information will result in delay in repair.
Help me find my model and serial number tag.
Dishwasher Tag
Dishwasher model and serial tags located on the inside frame on the opening of the door on the left or top of door by controls
Refrigerator Tags
Refrigerator model tag located inside the fridge compartment on the left hand side
Stove Tag
Stove model tag located under the cooktop lip. Stove model tag open the drawer on the left or right hand side by the legs.
Built in oven Tag
Built in oven model tag located on the frame on the left side when you open the oven door
Front Load Washer - Dryer Tag
Front load Washer Dryer model and serial tags located when you open the door on the frame of the opening
Top Load Washer Tag Lid
Top load washer model located on the inside of the lid.
Top Load Washer Tag Top
Top load washer model located on the top of the control panel.
Microwave Tag
Microwave located on the frame when you open the door
Phone
Dishwasher Tag
Dishwasher model and serial tags located on the inside frame on the opening of the door on the left or top of door by controls
Refrigerator Tags
Refrigerator model tag located inside the fridge compartment on the left hand side
Stove Tag
Stove model tag located under the cooktop lip. Stove model tag open the drawer on the left or right hand side by the legs.
Built in oven Tag
Built in oven model tag located on the frame on the left side when you open the oven door
Front Load Washer - Dryer Tag
Front load Washer Dryer model and serial tags located when you open the door on the frame of the opening
Top Load Washer Tag Lid
Top load washer model located on the inside of the lid.
Top Load Washer Tag Top
Top load washer model located on the top of the control panel.
Microwave Tag
Microwave located on the frame when you open the door
