Service Booking Confirmation

For Repairs, BOOK ONLINE (existing Reliance customers only) or call 1-888-837-1451.

For Regular Maintenance/Tune Up, please CLICK HERE.

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.

Appointment Details

“*” indicates required fields

Book Appointment *

Date*

Time*

Time Period*

Select time for a call back*

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

Yes, please let me know how I could get $500 off a HEPA filter for improved indoor air quality during my appointment.

Are you the home owner?*

Yes

No

Are you an Existing Reliance Water Heater Customer?*

Yes

No

Product to be serviced*

Type of issue you're experiencing*

Do you own or expect to have an Electric Vehicle in a month?*

Yes

No

Do you already have a Level 2 EV Charger?*

Yes

No

This field is hidden when viewing the form

glcid

This field is hidden when viewing the form

fclid

This field is hidden when viewing the form

impact_affiliate_source

This field is hidden when viewing the form

utm_source

This field is hidden when viewing the form

utm_medium

This field is hidden when viewing the form

utm_campaign

This field is hidden when viewing the form

utm_id

This field is hidden when viewing the form

mediaid

This field is hidden when viewing the form

campaignid

This field is hidden when viewing the form

affiliate_special_offer

This field is hidden when viewing the form

affiliate_order_id

This field is hidden when viewing the form

promocode

For Repairs, BOOK ONLINE (existing Reliance customers only) or call 1-888-837-1451.

For Regular Maintenance/Tune Up, please CLICK HERE.

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.

Contact Information

Name*

First Last

Email*

This field is hidden when viewing the form

email_sha_hash

Phone*

For Repairs, BOOK ONLINE (existing Reliance customers only) or call 1-888-837-1451.

For Regular Maintenance/Tune Up, please CLICK HERE.

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.

Location

Address*

Street Address Address Line 2 City Province Postal Code

Additional Details

Please describe the issue you are experiencing

Please describe the issue you are experiencing*

Newsletter Sign-Up

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

Phone

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

For Repairs, BOOK ONLINE (existing Reliance customers only) or call 1-888-837-1451.

For Regular Maintenance/Tune Up, please CLICK HERE.

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.

Your Appointment Has Been Confirmed!

Your Form Has Been Submitted Successfully!

Solutions For:

Reliance Support

Why Reliance?

Appointment Details

Contact Information

Location

Your Appointment Has Been Confirmed!

Your Form Has Been Submitted Successfully!

Newsletter Sign Up

Follow us:

Appointment Details

Contact Information

Location