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Full Name
*
Phone
*
Email Address
*
Service Address
*
City / Town
*
Item Description
*
Brand / Manufacturer
Model (if known)
Service Type
*
Packaging
*
Additional items or notes
Tools provided by client?
*
All hardware / parts included?
*
Missing hardware situation
Wall anchoring / mounting requested?
*
Describe what needs mounting
Previously assembled by someone else?
*
Condition of items
*
Pre-existing damages to note
Packaging disposal
*
Property Type
*
Stairs involved?
*
Number of flights
Elevator available?
*
Tight hallways or doorways of concern?
*
Describe access concerns
Requested Date
*
Flexible on Date?
*
Estimated Number of Items
Estimated Time Needed
Haul away old / replaced furniture?
*
Shelf installation requested?
*
TV mounting — screen size
Other add-ons
Printed Name
*
Date
*
Signature
*
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