Maintenance Request

Apartment Community*

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Preferred method of contact

Phone
Email

When would you like us to address your maintenance request?

As soon as possible
Schedule a time with me

WHAT TYPE OF MAINTENANCE CONCERN DO YOU HAVE?

Please be as detailed as possible.

Health Questionnaire

Due to COVID-19 we are asking all residents answer the following questions. We want to ensure we are keeping our staff and all residents safe.

I am not exhibiting any common flu symptoms i.e. fever, cough, or temperature.*

True
False

I have not had any person-to-person contact with someone who has exhibited coronavirus symptoms in the last 7 days.*

True
False

I have not visited an area where there has been a significant outbreak of coronavirus activity in the last 7 days.*

True
False

My employer has placed no restrictions on me related to conducting business at other worksites.*

True
False

Please note when you submit the Maintenance Request Form and have selected immediately for when you would like us to address your concern you have given our management company permission to enter your apartment. We will try our best to accommodate your schedule if you have selected Please Contact Me to Schedule a Time.

However in cases of emergency or necessity we may have to enter your apartment as soon as we receive your request.

Please put your initials in the box confirming that you agree to the procedures outlined above.*

Thank you for submitting your Maintenance Request.

Health Questionnaire

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College Park & Springbrook Row

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