Fix2 Bill — New Customer

Customer Details

Full Name *

Full name is required

Contact Person

Phone *

Phone number is required

Email Address *

Please enter a valid email address

Street Address *

Street address is required

Suburb * Suburb is required

State * Required

Postcode * Required

Job Description *

Notes

Confirm & Save

Review the customer details before saving

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DOMESTIC CUSTOMER

Contact Information

Phone

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Contact Person

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Job Description

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Notes

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Site Address

Street

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Suburb

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State / Postcode

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Equipment

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Group Handle Type

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Equipment Photos (optional)

Authorisation

Are you OK for us to go ahead with the repairs up to the value of $450 without being quoted first? (optional) I understand there is a minimum charge of $275 even if the repairs aren't completed.

Customer Signature *

Sign here

By signing, the customer agrees to the authorisation above.

Service Request

Authorisation

Repairs up to $450 authorised without a prior quote

$275 minimum charge acknowledged even if repairs aren't completed

Job Description * Please select a job description or choose Skip

Date

Priority

Assigned Technician

Equipment to Service

No equipment added in Step 2

Service Notes