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Service Request Form

To request service, please fill out the form below. Fully completed forms will help to expedite our response to you and your service. All fields are required.

Homeowner Contact Information

Title:

First Name:

Last Name:

Email Address:Email is confidential and will not be released

Phone Number:

Address:

City:

State/Province:

Zip/Postal Code:

My Pollard products were originally supplied for:

Renovation or Replacement ProjectNew Home Build

Builder Name:

Move-in Date:(YYYY/MM/DD)

Lot #:

Pollard Product Needing Service

WindowDoor

Windows

Type of Window

Double Hung (Top Pane)Double Hung (Bottom Pane)Double Hung (Both Panes)Single Hung (Top Pane)Single Hung (Bottom Pane)Single Hung (Both Panes)Casement (Operating)Fixed LiteHorizontal Slider (Fixed Pane)Horizontal Slider (Operating Pane)Awning

Color

Exterior and Interior:

Sizing

Visible Glass Measurement
Width (inches):
Height (inches):

Location of Window

Room and Floor:

Grills:

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Please write a description of the problem. For example, broken glass or frame, stress crack, condensation, moisture between glass panes, operating hardware, sashes hard to lift or crank open, lock latch assembly.

Additional windows:

Yes

Window #2

Type of Window

Color

Exterior and Interior:

Sizing

Visible Glass Measurement
Width (inches):
Height (inches):

Location of Window

Room and Floor:

Grills:

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional windows:

Yes

Window #3

Type of Window

Color

Exterior and Interior:

Sizing

Visible Glass Measurement
Width (inches):
Height (inches):

Location of Window

Room and Floor:

Grills:

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional windows:

Yes

Window #4

Type of Window

Color

Exterior and Interior:

Sizing

Visible Glass Measurement
Width (inches):
Height (inches):

Location of Window

Room and Floor:

Grills:

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional windows:

Yes

Window #5

Type of Window

Color

Exterior and Interior:

Sizing

Visible Glass Measurement
Width (inches):
Height (inches):

Location of Window

Room and Floor:

Grills:

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional windows:

Yes

Window #6

Type of Window

Color

Exterior and Interior:

Sizing

Visible Glass Measurement
Width (inches):
Height (inches):

Location of Window

Room and Floor:

Grills:

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional windows:

Yes

Window #7

Type of Window

Color

Exterior and Interior:

Sizing

Visible Glass Measurement
Width (inches):
Height (inches):

Location of Window

Room and Floor:

Grills:

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional windows:

Yes

Window #8

Type of Window

Color

Exterior and Interior:

Sizing

Visible Glass Measurement
Width (inches):
Height (inches):

Location of Window

Room and Floor:

Grills:

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional windows:

Yes

Window #9

Type of Window

Color

Exterior and Interior:

Sizing

Visible Glass Measurement
Width (inches):
Height (inches):

Location of Window

Room and Floor:

Grills:

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional windows:

Yes

Window #10

Type of Window

Color

Exterior and Interior:

Sizing

Visible Glass Measurement
Width (inches):
Height (inches):

Location of Window

Room and Floor:

Grills:

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Doors

Door Configuration

Single Swing DoorDouble Swing DoorPatio Door (Fixed Pane)Patio Door (Operating Pane)4 Lite Sliding Door (Fixed Pane)4 Lite Sliding Door (Operating Pane)

Swing Door Hinge as viewed from outside

Left HingedRight HingedCenter Hinged LeftCenter Hinged Right

Sizing

Visible Glass Measurement:Width (inches):Height (inches):

Visible Glass Measurement for Side Lite:Width (inches):Height (inches):

Location of Door

Room and Floor

Grills

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Please write a description of the problem. For example, broken glass or frame, stress crack, torn weatherstrip, hardware latch assembly, door not sliding/swinging properly, leak, dented door, moisture between glass panes (seal failure), screen not operating properly, damaged sill, condensation.

Additional Doors:

Yes

Doors #2

Door Configuration

Single Swing DoorDouble Swing DoorPatio Door (Fixed Pane)Patio Door (Operating Pane)4 Lite Sliding Door (Fixed Pane)4 Lite Sliding Door (Operating Pane)

Swing Door Hinge as viewed from outside

Left HingedRight HingedCenter Hinged LeftCenter Hinged Right

Sizing

Visible Glass Measurement:Width (inches):Height (inches):

Visible Glass Measurement for Side Lite:Width (inches):Height (inches):

Location of Door

Room and Floor

Grills

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional Doors:

Yes

Doors #3

Door Configuration

Single Swing DoorDouble Swing DoorPatio Door (Fixed Pane)Patio Door (Operating Pane)4 Lite Sliding Door (Fixed Pane)4 Lite Sliding Door (Operating Pane)

Swing Door Hinge as viewed from outside

Left HingedRight HingedCenter Hinged LeftCenter Hinged Right

Sizing

Visible Glass Measurement:Width (inches):Height (inches):

Visible Glass Measurement for Side Lite:Width (inches):Height (inches):

Location of Door

Room and Floor

Grills

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional Doors:

Yes

Doors #4

Door Configuration

Single Swing DoorDouble Swing DoorPatio Door (Fixed Pane)Patio Door (Operating Pane)4 Lite Sliding Door (Fixed Pane)4 Lite Sliding Door (Operating Pane)

Swing Door Hinge as viewed from outside

Left HingedRight HingedCenter Hinged LeftCenter Hinged Right

Sizing

Visible Glass Measurement:Width (inches):Height (inches):

Visible Glass Measurement for Side Lite:Width (inches):Height (inches):

Location of Door

Room and Floor

Grills

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

Additional Doors:

Yes

Doors #5

Door Configuration

Single Swing DoorDouble Swing DoorPatio Door (Fixed Pane)Patio Door (Operating Pane)4 Lite Sliding Door (Fixed Pane)4 Lite Sliding Door (Operating Pane)

Swing Door Hinge as viewed from outside

Left HingedRight HingedCenter Hinged LeftCenter Hinged Right

Sizing

Visible Glass Measurement:Width (inches):Height (inches):

Visible Glass Measurement for Side Lite:Width (inches):Height (inches):

Location of Door

Room and Floor

Grills

Clear Glass (No Grill Bars)Glass with Grill Bars

Reported Issue

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