To request service please fill out the form below. Fully completed forms will help to expedite our response to you and your service. All sections and fields are required, unless marked with asterisk (*).

Homeowner Contact Information

Title:
First Name:
Last Name:
Email Address:

Email is confidential and will not be released
Phone Number:
Alt. Email Address*:

Email is confidential and will not be released
Alt. Phone Number*:

My Pollard products were originally supplied for:

Builder Name:
Move-in Date:

(YYYY/MM/DD)
Lot #:

Service Request Location

Address:
City:
State/Province:
Zip/Postal Code:
Phone Number:

Service Request Time & Day

If you have a preference, please indicate the time period or day of the week that you would like your service to be scheduled for. While we will make all attempts to schedule the service according to your preference we cannot guarantee the time and day you chose will be available for Servicing in your area.

Preferred Time:
Preferred Day:

Product Information

In order to allow our Service Technicians to work effectively and efficiently please ensure clear access to your windows/doors is available. If required, please move all furniture, lamps, etc. including pets away from the area. It is mandatory that you fill out which window/door you would like serviced.

Pollard product needing service:

Windows

Sizing

Visible Glass Measurement
Width (inches)*:

Height (inches)*:

Grills:

Location of Window

Room and Floor:

Type of Window

Color

Exterior and Interior:

Reported Issue

Comments/Notes:

Please write a description of the problem


Please upload an image if one is available.

Additional windows:

Window #2
Sizing

Visible Glass Measurement
Width (inches)*:

Height (inches)*:

Grills:

Location of Window

Room and Floor:

Type of Window

Color

Exterior and Interior:

Reported Issue

Comments/Notes:

Please write a description of the problem


Please upload an image if one is available.

Additional windows:

Window #3
Sizing

Visible Glass Measurement
Width (inches)*:

Height (inches)*:

Grills:

Location of Window

Room and Floor:

Type of Window

Color

Exterior and Interior:

Reported Issue

Comments/Notes:

Please write a description of the problem


Please upload an image if one is available.

Additional windows:

Window #4
Sizing

Visible Glass Measurement
Width (inches)*:

Height (inches)*:

Grills:

Location of Window

Room and Floor:

Type of Window

Color

Exterior and Interior:

Reported Issue

Comments/Notes:

Please write a description of the problem


Please upload an image if one is available.

Doors

Door Configuration

Swing Door Hinge as viewed from outside

Sizing
Visible Glass Measurement:
Width (inches):

Height (inches):
Visible Glass Measurement for Side Lite:
Width (inches):

Height (inches):
Location of Door

Room and Floor

Grills

Reported Issue

Comments/Notes:

Please write a description of the problem


Please upload an image if one is available.

Additional Doors:

Doors #2
Door Configuration

Swing Door Hinge as viewed from outside

Sizing
Visible Glass Measurement:
Width (inches):

Height (inches):
Visible Glass Measurement for Side Lite:
Width (inches):

Height (inches):
Location of Door

Room and Floor

Grills

Reported Issue

Comments/Notes:

Please write a description of the problem


Please upload an image if one is available.

Please scroll to the top of the section to ensure you completed all applicable fields before submitting.