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Prudential Heating and Air Conditioning
3302 Gilmore Industrial Boulevard
Louisville, KY 40213

(502) 966-5813
(502) 966-3755
Online Form

Planned Service - Schedule

Welcome to our online service request form! If you need to schedule repair or maintenance, please fill out the information below as completely as possible along with desired dates and times. We will contact you during normal business hours to schedule or affirm the appointment.

If you require emergency service, please call (502) 966-5813.

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Contact Information

Full Name: Middle Inital, if any: Suffix, if any:
Street Address: Primary Phone #:
Address Line 2: Secondary Phone:
City: Email Address:
State: Time of day to reach you:
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Service Request Information

Yes No
Preferred day for service:

What brand is your furnace / AC Unit? Did we install the system? Yes No
How old is your
furnace / AC Unit?
When was the last time you had your system serviced?
What best describes the nature of the problem?
Please select:
Water Leak
No Heat No Cool
Insufficient Heat Insufficient Cool
Inside Unit Does Not Run Inside Unit Does Not Stop
Outside Unit Does Not Run Outside Unit Does Not Stop
Questions or Comments:

Choose the appropriate status for this project:
  Right Away / During Regular Business Hours
  At the Planning & Budgeting Stage

Is this request covered by an insurance claim? Yes No
Is this location a commercial location? Yes No
Do you own the home for this request? Yes No
Do we need a ladder to access the unit? Yes No
If Yes, how tall? (in feet)

How did you hear about our website? (Select all that apply):
  Yellow Pages
  Referred by Customer Newspaper Ad
  Google Search Engine Radio Ad
  Yahoo Search Engine Signs / Billboards
  Received E-mail Postcard
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