Gentry Air, Inc.

Please complete the information below to request a service call. A Service Representative from Gentry will contact you promptly.

IMPORTANT-PLEASE NOTE: IF THIS IS AN EMERGENCY CALL,
DO NOT COMPLETE THIS FORM. For emergency service after 5:00pm, weekends or holidays, please call our 24 hour service number at (336) 621-1070.

YOUR NAME:

SERVICE ADDRESS:

CITY:

STATE & ZIP:

IF YOU ARE A NEW CUSTOMER, HOW DID YOU HEAR ABOUT OUR COMPANY?

BEST METHOD TO CONTACT YOU:
HOME PHONE: BUSINESS:
CELL PHONE:
E-MAIL:

REQUESTED SERVICE TIME: 8:00AM - NOON NOON - 4:00PM

REQUESTED SERVICE DATE:

SYSTEM NEEDING REPAIR: Heating Air Conditioning Other

PROBLEM DESCRIPTION: