---
title: Maintenance request form template, free
description: A free maintenance request form template. Report a repair: what and where, how urgent, permission to enter, photos, and sign-off when fixed. Publish it as one link; every response is its own signed copy.
---

# Maintenance request

Report a repair: what and where, how urgent, permission to enter, photos, and sign-off when fixed.

Log every repair request with permission to enter and a signed completion.

## About you

- Full name (text)
- Email (email)
- Phone (phone, optional)
- Street address (text)
- City (text)
- State or region (text)
- ZIP or postal code (postal code)

## The problem

- Unit or room (text)
- Description (text)
- Category (choice)
- Urgency (choice)
- Started (text, optional)
- Photos (file (PDF or picture), optional)

## Access

- Maintenance staff may enter to fix this if I am not at home. (tick box)
- Access note (text, optional)

## Signature

- Occupant signature (signature)
- Occupant date signed (date signed)

## For maintenance use

- Decision (choice)
- Note (text, optional)
- Maintenance signature (signature)
- Maintenance date signed (date signed)