Service Request Form

Contact Info

Service Needed

Details

Review

Your Contact Information

Full Name *

Email *

Phone Number *

Property Address *

What Service Do You Need?

Select Service(s) *

Describe Your Project *

Additional Details

When Do You Need This Done? *

🚨 Emergency
Within 24h

⚡ ASAP
This week

📅 Soon
2 weeks

🗓️ Flexible
This month

Preferred Date/Time

Upload Photos (Optional)

📸

Click to upload photos

Or drag and drop images here

Budget Range (Optional)

Additional Notes

Review Your Request

📋 Contact Information

Name:

Email:

Phone:

Address:

🔧 Service Details

Services:

Description:

Urgency:

Preferred Time:

Budget:

Photos:

✅

Request Submitted Successfully!

Thank you, ! We've received your service request and it's been sent to our team at Lehigh Valley Home Help & Services.

📋 Download Your Service Request PDF

Click the button below to download a PDF copy of your service request. This includes all your details, photos, and information for your records.

💡 Tip: Save this PDF and share it with any contractor who comes to look at your project!

🎯 What Happens Next?

1 We review your request and match you with the best contractor from our vetted network

2 You'll receive a call or email within 24 hours (sooner for emergencies!)

3 The contractor will contact you to schedule an estimate or site visit

4 Get a detailed estimate and schedule your service!

📞 Questions? Call us at (610) 555-1234 or email [email protected]

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