Appliance Repair Intake Forms & Client Questionnaires

A customer calls and says their refrigerator stopped cooling. That single sentence could mean a failed compressor, a dirty condenser coil, a bad thermostat, a sealed system leak, or a defrost timer that gave out — and the difference between those diagnoses determines whether your tech needs a multimeter and a capacitor or a recovery machine and three hours of labor. The model number narrows the field before you even leave the shop, the serial number tells you whether the unit is under manufacturer warranty, and the age of the appliance tells you whether the repair is worth doing at all. Most appliance repair companies capture none of this before dispatch and pay for it in wasted trips, incorrect parts orders, and callbacks.

The Appliance Repair intake form is built for the way appliance service companies actually work. It captures the appliance type — refrigerator, freezer, washer, dryer, dishwasher, oven, range, cooktop, microwave, garbage disposal, trash compactor, ice maker, wine cooler, or combination unit — along with the brand, model number, serial number, and approximate age. It records fuel type (electric, gas, or dual fuel), voltage requirements (120V vs. 240V), and whether the unit is built-in, freestanding, or stacked. These details determine which parts catalog your tech references, which tools go on the truck, and whether a gas shutoff valve needs to be located before work begins.

Symptom Documentation and Error Codes

Modern appliances are increasingly computerized, and a blinking error code on a Samsung refrigerator or an F-code on a GE oven is the fastest path to diagnosis — if it gets captured at intake. The form includes a dedicated section for error codes displayed on the unit, plus a structured symptom checklist organized by appliance type: not cooling, not heating, not draining, excessive noise, leaking water, won’t start, won’t spin, door won’t latch, ice buildup, burning smell, tripping the breaker, or intermittent operation. It asks when the problem started, whether it is constant or intermittent, and whether the customer has noticed any changes in performance leading up to the failure — a refrigerator that gradually stopped cooling over two weeks points to a sealed system leak, while one that quit overnight points to an electrical component.

The form also captures what the customer has already tried. A homeowner who unplugged and replugged the refrigerator, cleaned the coils, and checked the thermostat setting has already eliminated several common causes. A homeowner who called another company first and was quoted $1,200 for a compressor is looking for a second opinion. Both situations change how your tech approaches the service call, and both are worth knowing before arrival.

Warranty, Parts, and Access Requirements

Warranty status directly affects your repair workflow. If the unit is under manufacturer warranty, your tech may need to use OEM parts exclusively, document the failure with photos for the warranty claim, and follow the manufacturer’s repair protocol rather than your standard procedure. The form captures purchase date, warranty expiration, extended warranty or home warranty plan details, and whether the customer has already filed a claim. For out-of-warranty repairs, it captures the customer’s preference on part sourcing: OEM parts only, aftermarket acceptable, or refurbished acceptable — because a $45 aftermarket control board and a $180 OEM control board both fix the problem, but some customers want the factory part regardless of cost.

Access requirements matter for appliance repair more than most trades. A built-in refrigerator in a custom kitchen may require removing trim panels and adjacent cabinetry. A stacked washer-dryer in a closet may need the top unit removed before the bottom unit can be serviced. A gas range in an island needs the gas line shut off at a valve that may be behind the unit. The form captures installation type, access constraints, and utility connection details — water supply lines, gas connections, dedicated electrical circuits, and drain locations — so your tech arrives prepared for the physical reality of the job, not just the appliance itself.

Intake vs. Client Questionnaire

The intake form is your internal dispatch document. Your office staff or call center fills it out during the initial call, recording the appliance details, symptoms, customer contact information, service address, access instructions, and scheduling preferences. It includes fields for priority level, estimated repair complexity, and dispatcher notes. The companion client questionnaire is what you email or text to the customer before the appointment. It asks them to locate the model and serial number (with instructions on where to find the nameplate for each appliance type), describe the problem in their own words, note when it started, photograph any error codes displayed, and confirm access details like gate codes, parking instructions, and whether pets will be secured. Sending this before the visit means your tech arrives with the right parts on the truck instead of making a diagnostic trip followed by a return trip with the correct components.

Pricing

Each form is $12.99 for the complete set (intake + questionnaire), $9.99 for intake only, or $6.99 for questionnaire only. All PDFs are fillable in Adobe Reader and password-protected against editing.

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