Service Request Form | Veritas Electric

Do you have a promo code?

Promo Code

Please fill separate Service Request for each required service.

Required Service

Service urgency *

Select type of service *

Select building type *

Additional information (if you selected "Other")

Select required service *

Description of service (if you selected "Other")

Contact Information

Your Last Name *

Your First Name *

Your relation to property *

Specify (if you selected "Other")

Service request is for *

Enter company name (if you selected "Company/ Organization")

Enter your title (if you selected "Company/ Organization")

Preferred contact *

Cell Phone *

Work Phone

Ext.

Home Phone:

Email *

When is the best time to contact you? *

Any Time

Morning

Afternoon

Evening

Service Location

Address *

City *

Province *

Postal Code *

Your Address (fill only if different from service location above)

Address

City

Province

Postal Code

Call 24/7: (416) 929-8216 e-mail: Master@VeritasElectric.ca

ECRA/ESA 7011954

VERITAS ELECTRIC

General Electrical Contractor

Service Request

Do you have a promo code?

Required Service

Contact Information

Service Location

Your Address (fill only if different from service location above)

Additional Comments

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