Contractor Program

Please fill out the fields in the form and click SUBMIT.

You will receive an email confirmation shortly afterwards with the Customer’s name.

The Customer will also receive an email confirmation with the details submitted in the form along with all the appointment details (if applicable).

If you do not receive the confirmation message within a few minutes, please check your junk/spam folder and add info@reliancehomecomfort.com to your Safe Senders List.

In the event that an appointment needs to be scheduled/rescheduled, a Reliance Team Member will contact the Customer directly through the contact information provided.

Call on Reliance^™ for all your home comfort needs.

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Book an in-home appointment

Complete the form below to schedule a consultation with one of our Home Comfort Advisors or service appointment

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CUSTOMER APPOINTMENT DETAILS

Book Appointment *

Date*

Because we know your repair and service needs are urgent, please call us at 1-888-837-1451 to book a service appointment

Yes, I'd like a free water quality test and water purification consultation during my appointment.

Yes, I’d like a free water quality test and water purification consultation during my appointment.

CUSTOMER CONTACT INFORMATION

Name*

First Last

Email*

Phone*

CUSTOMER LOCATION

Address

Street Address Address Line 2 City

Province Postal Code

CONTRACTOR INFORMATION

Contractor Full Name*

First Last

Contractor ID*

Contractor Email

Additional Details

Newsletter Sign-Up

Yes, I’d like to be signed up for the Reliance Newsletter.

If you’re not covered under our existing services there will be a $99 diagnostic fee – the diagnostic fee is waived if you proceed with the service at the time of your appointment.

Name

This field is for validation purposes and should be left unchanged.

By completing this request for a quote and voluntarily providing your personal information, you consent to the collection and use of such information by us for the purposes of responding to your request by email and/or phone and assisting with the in-home sales appointment you have scheduled. You are welcome to review our Privacy Policy by clicking Here.

Contractor Referral Form

Thank you for contacting Reliance^® on behalf of your Customer.

Book an in-home appointment

CUSTOMER APPOINTMENT DETAILS

CUSTOMER CONTACT INFORMATION

CUSTOMER LOCATION

CONTRACTOR INFORMATION

If you’re not covered under our existing services there will be a $99 diagnostic fee – the diagnostic fee is waived if you proceed with the service at the time of your appointment.

Solutions For:

Reliance Support

Why Reliance?

Appointment Details

Contact Information

Location

Contractor Referral Form

Thank you for contacting Reliance® on behalf of your Customer.

Book an in-home appointment

CUSTOMER APPOINTMENT DETAILS

CUSTOMER CONTACT INFORMATION

CUSTOMER LOCATION

CONTRACTOR INFORMATION

If you’re not covered under our existing services there will be a $99 diagnostic fee – the diagnostic fee is waived if you proceed with the service at the time of your appointment.

Newsletter Sign Up

Follow us:

Appointment Details

Contact Information

Location

Thank you for contacting Reliance^® on behalf of your Customer.