Centigrade Ltd Online Booking Request

Please complete this form to discuss a potential booking..

The more information you can give the better service we can provide.

Customer Details

Name *

Title

Email Address

Text Number

Phone Number

Address Postcode

Address Line 1

Address Line 2

Address Line 3

Address City

Address County

Address Country

Property Directions

Alternative Email Address

Job Details

Appliance Type *

Appliance Make

Model Number

Serial Number

Product Code

Job Request Came From *

Fault Details

Job Info and Fault Details as reported by customer *

Customer supplied image / video

Warranty Details

DOP

Authority / 3rd Party Job reference

Retailer

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