Appointment Request Form

WOOTEN APPLIANCE Appointment or Service Request

~~We do NOT service Asko, Fisher Pakel, Meile, Summit, or Thermador~~
****Fridge or freezer must be plugged in & running at appointment in order to diagnose problem****
Property owner name*

First NameLast Name
Cell Phone*

Area CodePhone Number
Home Phone*

Area CodePhone Number
Work Phone

Area CodePhone Number
Email*
Are you a previous customer?*

YesNo
Do you reside at the property where the appliance is located?*

YesNo
Tenant name if applicable

First NameLast Name
Tenant contact number

Area CodePhone Number
Tenant email
Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which county in the US is your city located?*

Anne ArundelBaltimoreHowardMontgomeryPrince GeorgeWashington, DC
How were you referred?*

Angies ListCraigs ListDADS ApplianceFive StarFriendInternetNeighborhood List ServPrevious CustomerWooten WebsiteYelpOther
What day/days work best for you? We will do our best to schedule for your preferred day. A diagnostic service fee applies to all initial visits.*

MondayTuesdayWednesdayThursdayFriday
Please note first appliance type and problem or question with as many details as possible. *
1st Appliance Brand*
Please note second appliance type and problem or question with as many details as possible.
2nd Appliance Brand
Please note third appliance type and problem or question with as many details as possible.
3rd Appliance Brand
Type "NO COUPON" OR note if using ANGIES LIST COUPON & include AMOUT THE COUPON IS FOR ($20 new customer, $139 or $159 Large Appliance Repair)*
Should be Empty:

WOOTEN APPLIANCE Appointment or Service Request

****Fridge or freezer must be plugged in & running at appointment in order to diagnose problem****

Fridge or freezer must be plugged in & running at appointment in order to diagnose problem