Service Request

This form will enter your information onto the Log for processing and scheduling of work. For emergencies please call instead of using this form.

This form allows us to eliminate the use of a paper service log and allows the Technician to already have a Work Ticket pre-filled with all of your appropriate information for efficient scheduling.

Please do not submit multiple service requests for follow ups or questions. Any follow ups or changes to the original request, please simply reply to the ticket confirmation email you received.

Please wait a moment if the form is not on the page when it loads, it is still loading in the background and may take a few seconds to appear. If the form does not appear, you can email your request to Info@CharlotteBackflow.Com or Click Here