Daxom call out form

Customer Name *

Address *

Telephone Number *

Email *

Boiler Model *

Serial Number *

Date of Purchase *

Date of Installation

Name of Installer *

Contact Details *

Date of Warranty registration *

Do you have

Radiator heating?

Underfloor heating?

Lime Scale Inhibitor installed?

Heating Circuit Magnetic Filter installed?

Corrosion inhibitor in line with BS7593:1992 added to the heating system?

Room thermostat installed?

Thermostatic radiator valves installed?

Electrical installation Certificate?

Problems encountered

If you are human, leave this field blank.