MAINTENANCE REQUEST CHECKLIST Created by ChecklistGuro (https://checklistguro.com) --- REQUESTOR INFORMATION --- [ ] Requestor Name [ ] Requestor Phone Number [ ] Requestor Email Address [ ] Unit/Apartment Number (if applicable) [ ] Date of Request [ ] Preferred Contact Time (Optional) [ ] Relationship to Property (Owner/Tenant/Guest) (Owner, Tenant, Guest, Other) --- PROPERTY INFORMATION --- [ ] Property Address [ ] Unit/Apartment Number [ ] Property Type (Single Family Home, Condominium, Apartment, Townhouse, Commercial, Other) [ ] Building Name (if applicable) [ ] Date of Occupancy (for reference) [ ] Lease Agreement ID (if applicable) --- ISSUE DESCRIPTION --- [ ] Detailed Description of the Issue [ ] Approximate Size of Affected Area (e.g., square feet) [ ] Which of the following best describe the issue? (Plumbing, Electrical, HVAC, Structural, Appliance, Cosmetic, Other (Specify in Long Text)) [ ] Specific Details or Circumstances Related to the Issue (e.g., when does it occur, what triggers it?) [ ] Upload Photos or Videos of the Issue (Optional but Recommended) [ ] Precise Location of the Issue within the Property (e.g., Master Bathroom, 2nd Floor Hallway) --- SEVERITY & URGENCY --- [ ] Severity Level (Emergency - Immediate Danger, High - Significant Impact/Potential Hazard, Medium - Disruptive but not Hazardous, Low - Minor Inconvenience) [ ] Urgency (ASAP - Within 24 Hours, Within 3 Days, Within 7 Days, Scheduled - No Immediate Need) [ ] Estimated Impact Score (1-10) [ ] Briefly Explain Urgency Justification [ ] Desired Completion Date (if applicable) --- INITIAL ASSESSMENT & DIAGNOSIS (TECHNICIAN) --- [ ] Detailed Description of Observed Issue [ ] Temperature Reading (if applicable) [ ] Possible Cause (Initial Assessment) (Wear and Tear, Damage, Malfunction, Environmental Factors, Unknown) [ ] Affected Systems (Check all that apply) (Plumbing, Electrical, HVAC, Structural, Roofing, Appliances, Exterior, Interior) [ ] Photos/Videos of Issue (Optional) [ ] Estimated Time to Complete (Hours) [ ] Date of Assessment [ ] Time of Assessment [ ] Precise Location of Issue --- WORK PERFORMED & MATERIALS USED (TECHNICIAN) --- [ ] Detailed Description of Work Performed [ ] Trade(s) Involved (e.g., Plumbing, Electrical, Carpentry) (Plumbing, Electrical, Carpentry, HVAC, Painting, General Repairs, Other) [ ] Labor Hours Spent [ ] Estimated Labor Hours (if different from actual) [ ] Materials Used – Description and Quantity [ ] Cost of Materials [ ] Photos of Work Completed (Before & After) [ ] Any Unexpected Issues Encountered? (Yes, No) [ ] Details of Unexpected Issues (If Applicable) --- RESOLUTION & VERIFICATION --- [ ] Was the issue resolved to your satisfaction? (Yes, No, Partially Resolved) [ ] If no or partially resolved, please explain: [ ] Are there any remaining concerns? (Yes, No) [ ] If yes, please describe any remaining concerns: [ ] Date of Verification [ ] Requester Signature (Verification) --- DOCUMENTATION & SIGN-OFF --- [ ] Technician Signature (Confirmation of Work) [ ] Requestor Signature (Confirmation of Resolution) [ ] Date of Completion [ ] Photos/Videos of Completed Work (Optional) [ ] Overall Satisfaction Level (Excellent, Good, Fair, Poor) [ ] Additional Comments or Notes (Optional) --- END OF TEMPLATE --- Transform this text into a digital, automated, and trackable mobile app! Visit: https://checklistguro.com/templates/facility-management/maintenance-request-checklist (Click "Install Template" to launch your digital inspection tool immediately)