CUSTOMER INFORMATION FORM (Departure)

 

Date of Service *
Date of Service
This is the time that the movers moved your last item in/out, assembled/disassembled your last item, removed the last packing materials from your location.
Customer's Name *
Customer's Name
If no concerns, please state there are no concerns.
Check to indicate if there were any damages, issues, or concerns. *
If no items were damaged please indicate so below:
$
Can we utilize the information provided by you regarding our services, which includes your information (first name, last initial, email, and/or phone) for review boards and in other places to assist us in acquiring additional jobs? You can indicate parts of your contact information that we can use and we will honor this. Please let us know, as this is integral to us getting additional jobs and we also value your input.