Fitness Equipment Work Order Request Form
Submit a request for maintenance or repair of fitness equipment. Please complete all relevant details to ensure a prompt response.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Equipment Type
*
Please Select
Treadmill
Elliptical
Stationary Bike
Rowing Machine
Weight Machine
Other
Equipment ID or Serial Number
Location (Room, Area, or Facility)
*
Describe the Problem or Service Needed
*
Priority
*
Low
Medium
High
Preferred Date for Service
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preferred Time
Hour Minutes
AM
PM
AM/PM Option
Submit Request
Should be Empty: