ServiceReserve
Free form template

Appliance repair booking form template with the brand and model up front.

A free appliance repair booking form that collects the brand, model, symptom, and warranty status before you dispatch. The form on this page is interactive, so try it. Use it on Google's Book online button, embed it on your website, or share it as a link.

Use this template freeBuild it free · start your 30-day trial when you go live

Try it: the form on this page is interactive. Pick a service, answer the questions, and step through to the confirmation.

RA

Reliable Appliance Repair

5520 N Broadway, Chicago IL · (773) 555-0163

Select Services

Choose your services

Select the specific services you need.

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Questions in this template, and why they matter

QuestionTypeWhy ask it
What brand is the appliance?(required)Whirlpool · GE · Samsung · LG · Frigidaire · Bosch · KitchenAid · OtherDropdownBrand decides which parts supplier, service manual, and tech certification the job needs.
Model number, if you have itShort textWith the exact model, you can check part availability and pricing before the truck leaves.
What is the appliance doing?(required)Won't turn on · Not cooling or not heating · Leaking water · Not draining · Making a noise · Showing an error code · OtherDropdown (multi)The symptom narrows the likely failed part, so the tech can load it before the visit.
Is it gas or electric?Gas · Electric · Not sureRadioGas dryers and ranges need different parts, and some techs aren't set up for gas work.
How old is the appliance?Under 2 years · 2–5 years · 6–10 years · Over 10 years · Not sureDropdownAge frames the repair-or-replace conversation and hints at whether parts are still made.
Is it under manufacturer warranty?Yes / NoWarranty jobs may need to go through the manufacturer, so you can route or decline them early.
Photo of the model and serial number tagFile uploadA photo of the tag removes typos in the model number and shows the serial for warranty checks.
Anything else the technician should know?Long textCatches access notes, error codes, and recent repair attempts that don't fit the other questions.

How to use this template in ServiceReserve

  1. 1

    Sign up and pick Appliance Repair

    Your booking form starts with the Appliance Repair services: Refrigerator, Freezer, Washing Machine, Dryer, and more. Rename, reprice, or remove any of them.

  2. 2

    Add the questions

    Open Services and add the questions above to the whole form, a category, or a single service. Mark the ones you can't dispatch without as required.

  3. 3

    Set your area and arrival windows

    Add the ZIP codes you cover in Service areas and choose how customers pick a time in Schedules.

  4. 4

    Publish it where customers find you

    Turn on the Book online button on Google, embed the form on your website, or share a link or QR code.

Tips for a better appliance repair request form

  • Picking Appliance Repair at sign-up gives you a brand dropdown and a manufacturer-warranty Yes / No already on the form; edit the brand list to match the brands you service.
  • Keep model number optional and ask for a photo of the tag instead, since many customers can't find or read the tag on their first try.
  • Attach appliance-specific questions, like ice maker or door seal, to a single service in Services so the refrigerator form doesn't ask dishwasher questions.
  • Offer arrival windows such as Morning / Afternoon in Schedules rather than exact times, since diagnostic visits run long when a part is hard to reach.
  • Put the diagnostic fee on each service and turn on Show prices so customers know the cost of the visit before they book.

The question list, ready to copy

Use it in ServiceReserve or any form builder.

1. What brand is the appliance? (required) — Dropdown: Whirlpool, GE, Samsung, LG, Frigidaire, Bosch, KitchenAid, Other
2. Model number, if you have it — Short text
3. What is the appliance doing? (required) — Dropdown (multi): Won't turn on, Not cooling or not heating, Leaking water, Not draining, Making a noise, Showing an error code, Other
4. Is it gas or electric? — Radio: Gas, Electric, Not sure
5. How old is the appliance? — Dropdown: Under 2 years, 2–5 years, 6–10 years, Over 10 years, Not sure
6. Is it under manufacturer warranty? — Yes / No
7. Photo of the model and serial number tag — File upload
8. Anything else the technician should know? — Long text

Frequently asked questions

Does ServiceReserve include the appliance brand list?

Yes. When you pick Appliance Repair at sign-up, your form starts with a brand dropdown and a manufacturer-warranty question. You can add brands, remove ones you don't service, or change the wording.

Can customers upload a photo of the model tag?

Yes. Add a File upload question to the whole form or to specific services. The photo arrives with the booking in Requests, next to the other answers.

Can I show my diagnostic fee on the form?

Yes. Set a price on each service and turn on Show prices. You collect payment your usual way; the form shows the fee so there are no surprises at the door.

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