* Required FieldName* First Last Fireplace Address* Street Address Address Line 2 Suburb State Postcode Primary Contact Name First Last Primary Contact Number*Secondary Contact Name First Last Secondary Contact NumberEmail Address* Purchased FromPurchase Date Invoice NumberInstall Date Model Number*Serial Number*System Type*(Please select one)Natural GasLPGUnsureService callout - $230 plus partsDescription of ProblemTerms and Conditions*(Please tick all the boxes) I am aware of the above service charge (please note - cost for a Mezzo unit is $330) plus the cost of any parts used. I understand that warranty issues have to be determined by the technician on site. I understand that I am not to use the fireplace on day of service - $125 fee may apply. A cancellation within 24 hours of the booking time may incur a $75 cancellation fee. Entered By*CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.