Schedule your heating or air conditioning energy saving preventative maintenance check using this form.

Scheduling

Thank you for choosing our company to take care of your home comfort needs!

Please note, however, that this form is for requesting routine service only. If you have an emergency, please call our office number (24/7) and speak to a live person who will help you immediately.

	Maintenance checks can be scheduled up to 6 months in advance.
	In order to provide the fastest emergency service possible, please request maintenance checks 4-8 weeks in advance.
	Order will be confirmed before work begins.
	Please supply the information requested below; * fields are required.

Contact Information

Name *

First

Last

Service Address *

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Phone Number *

###

####

Email *

Appointment Information

Preferred Date

Waiting List

Yes, I would like to be put on a waiting list for an appointment earlier than the current scheduling. We will call you at the contact number above if an earlier appointment becomes available, possibly the same day.

Preferred Arrival

8-12

12-4

Premium Members

Preferred Arrival

8-12

12-4

2-6

Preferred Contact

Phone

Preferred Technician

If the above tech is unavailable, I

want to reschedule

do not want to reschedule

Key or Realtor

Property is *

Tenant's Name

Call On Your Way

Yes, please call me at the above contact number when you're on your way!

Service Information

Service Needed *

New HVAC Agreement

New Plumbing Agreement

New Water Heater Agreement

New Winterization Agreement

HVAC Maintenance Check

Other, Please Describe in Comments Box

Spare Filter Located

Filters

I need them! Please ship a case to my home before my maintenance check and bill me for them.

Comments

Confirmation *

I understand that I will receive a phone call or an e-mail to confirm my appointment within 2 business days. If I do not receive confirmation, I understand that my appointment has not been scheduled.

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Custom Mechanical, Inc.

Parts & Supplies

Custom Sheet Metal

P.O. Box 1479, Bethany Beach, DE 19930

(302)539-5177 & (800)233-5177 · Fax (302)537-5191

Office Hours 8:00 AM - 5:30 PM M-F, Sat. in Season

Emergency service available 24 hours a day!

34799 Daisey Road, Frankford

Phone (302) 537-1150

Fax (302) 539-9106

7:30-4:30 M-F & Sat. in Season

34799 Daisey Road, Frankford

Phone (302) 537-5611

Toll Free (877) 537-5611

Open 7:00-3:30 M-F

Licensed and insured: HVAC DE #HM-0000111, HVAC MD #01-5841, Plumbing DE #00653, Plumbing MD #71211, Electrical DE #T1-0004050, Electrical MD #11823 & Worcester County #M1043