ServiceReserve
Free form template

Plumbing service request form template that tells you what's leaking.

A free plumbing service request form that asks what's wrong, where it is, and whether water is running right now. The form on this page is interactive, so click through 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.

PP

Pacific Plumbing & Heating

2400 Broadway, Oakland CA · (510) 555-0180

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Select the specific services you need.

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Questions in this template, and why they matter

QuestionTypeWhy ask it
What do you need help with?(required)Clogged drain · Leak · Water heater · Toilet · Faucet or fixture · Sewer backup · Low water pressure · OtherDropdownProblem type decides whether you send a drain machine, a water heater tech, or a general service plumber.
Where is the problem?Kitchen · Bathroom · Laundry room · Basement or crawlspace · Water heater area · Outside or yard · OtherDropdown (multi)Location hints at access and which fittings or snake length the tech will need.
Is water actively leaking right now?(required)Yes / NoAn active leak moves the job to the front of the line and may need a call back within minutes.
Have you shut off the water to the fixture or the house?Yes / NoIf the answer is no, the office knows to walk the customer to the shutoff while the truck is on its way.
If it's the water heater, what type is it?Tank, gas · Tank, electric · Tankless · Not sureDropdownTank vs. tankless and gas vs. electric decide the parts, the venting, and the replacement quote.
Upload a photo of the problemFile uploadA photo of the leak, stain, or fixture shows how bad it is and what brand of fixture you're dealing with.
Describe what's happeningLong textDetails like "only when the dishwasher runs" often point straight to the cause.

How to use this template in ServiceReserve

  1. 1

    Sign up and pick Plumbing

    Your booking form starts with the Plumbing services: Repair, Drain Cleaning, Water Heater, Leak Detection, 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 plumbing request form

  • Require problem type and is water leaking right now; those two answers are enough to triage, and everything else can stay optional.
  • Attach the water heater type question to the Water Heater service in Services so drain customers never see it.
  • Keep true emergencies on the phone if you prefer, and put scheduled work like drain cleaning and fixture installs on the form.
  • Offer arrival windows in Schedules instead of exact start times, since plumbing jobs rarely finish on schedule.
  • Use a Text block at the top of the form to tell customers with a burst pipe to call you directly.

The question list, ready to copy

Use it in ServiceReserve or any form builder.

1. What do you need help with? (required) — Dropdown: Clogged drain, Leak, Water heater, Toilet, Faucet or fixture, Sewer backup, Low water pressure, Other
2. Where is the problem? — Dropdown (multi): Kitchen, Bathroom, Laundry room, Basement or crawlspace, Water heater area, Outside or yard, Other
3. Is water actively leaking right now? (required) — Yes / No
4. Have you shut off the water to the fixture or the house? — Yes / No
5. If it's the water heater, what type is it? — Dropdown: Tank, gas, Tank, electric, Tankless, Not sure
6. Upload a photo of the problem — File upload
7. Describe what's happening — Long text

Frequently asked questions

Can I use this as a work order request form without booking times?

Yes. Leave the scheduling step off and the form works as a request form. Each submission lands in Requests with every answer, and you get an email notification.

Can customers upload photos of the leak?

Yes. Add a File upload question to the whole form or only to services like Leak Detection. The photos arrive with the request.

Can I stop requests from outside my service area?

Yes. Add the ZIP codes you cover in the Service Area step. Customers outside them see an out-of-area message and can't finish the form.

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