Service Request Form

If you are requesting services for more than 1 piano, please submit 1 form per piano

Name*

Email and/or Phone Number*

Town and/or Address*

Piano Type*

Grand

Upright

Piano Brand*

Condition of your piano*

Brand New

Good

Okay

Poor

Awful

Years since last service*

Type of service*

Tuning

Regulation

Repair

Cleaning

Other (please describe desired service below)

(Other Service)

Notable Concerns (Sticky keys, stuck pedals, buzzes or rattles, ect.)*

WINTER WOOD PIANO WORKS

David Rule

Phone: 802-369-9473

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