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Online Plumber-Rooter Service Form

All items marked with an * are required to submit the form. Please be sure to fill them out completely.

Section 1.)

I need Plumber-Rooter Services.

Please call me for an appointment as soon as possible to arrange for access.


*Name:
*Address:
*Town:
*Zip:
*Home #:

*Daytime #:


*Email :
Please add my name to your e-mail list for future septic cleaning reminder notices.

I am already a Plumber-Rooter / Kaiser-Battistone customer.

Please tell us the nature of your problem:



Please tell us how you heard about us:

Comments, Special Instructions, Services Required,
& Phone Calling Details:


Section 2.)

We accept all major credit cards. Please indicate how you would like to remit payment.

Payment will be made via credit card.
[we utilize secure servers, your credit card information is encrypted.]


Billing Address if Different than in Section 1

Credit Card Type:

Credit Card Number:

Expiration Date (mm/yyyy)

 

Payment will be made via check.

What is 2+2?(Hint: The answer is 4). This is used to stop spam robots.

Thank you for being a Plumber-Rooter Internet Customer. All our Web Site promotions and discounts will be applied after payment has been received.

We appreciate your business.

 
 

 

 

 

 

Residential,
Commercial, Institutional, Municipal & Governmental.


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1-800-525-6295