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First Name*

Last Name*

Address*

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Home Phone*

Work Phone

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Are you currently a Tempo Customer?
(yes/no drop down box)

Preferred day for service   Select One Monday Tuesday Wednesday Thursday Friday

Preferred time for service   Select One 8-10 10-12 12-2 2-4 4-6

Alternate day for service   Select One Monday Tuesday Wednesday Thursday Friday

Alternate time for service   Select One 8-10 10-12 12-2 2-4 4-6

Best time to contact you    Select One Morning Afternoon Evening

Best way to contact you Select One Home Phone Work Phone Cell Phone

Nature of Problem: (check all that apply)
Not Cooling
Insufficient Cooling
No Heating
Insufficient Heating
Outside unit does not run
Inside unit does not run
Outside unit does not stop
Inside unit does not stop
System is noisy
Water leak
Maintenance Check
Poor Airflow from Vents
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How did you hear about Tempo’s website? (check all that apply)
I received something in the mail
I saw a Tempo truck
I was referred by a Tempo customer
In the Yellow Pages
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I am a current customer
Referred by Manufacturer’s Website
I don’t remember
Other   

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