Previous Customer Previous Customer Yes No

First Name

Last Name

Address

City

State

Zip Code

Phone

Email Address

Referred By

Phone Type Phone Type Home Cell

Service(s) Requested Service(s) Requested Grill Cleaning Grill Repair

Is the grill accessible from outside? Is the grill accessible from outside? Yes No

Is the grill built-in? Is the grill built-in? Yes No

Are there any drawers, cabinets, sinks or side burners that need cleaning? Are there any drawers, cabinets, sinks or side burners that need cleaning? Yes No

Working electrical outlet nearby? Working electrical outlet nearby? Yes No

Working water spigot nearby? Working water spigot nearby? Yes No

Grill Make

Grill Model

Approximate Grill Age

Number of Burners

Important info we need to know regarding the grill, location, and logistics.