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

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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, I would like a free, no-obligation sales consultation about my indoor air quality system 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

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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*

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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 Unit # 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.

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.

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