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Service Request

Important Notification

This Service Request form is for ROUTINE service requests only!

DO NOT USE THIS FORM FOR EMERGENCY DELIVERIES

Please use this form to file routine service requests. Please understand that depending on the day and time of your request, it could take 2-3 days to hear back from a representative of Proulx Oil & Propane.

Required fields are denoted with a red asterisk (*).

*Check all that apply:
Need annual cleaning & service
Would like a quote to add to existing heating system
Would like a quote to add central air conditioning
Interested in a log set for an existing fireplace
Interested in a system to heat an 'area' or a room in a house
I want to talk to someone about the cost to add propane to my home
I am interested in a quote to replace my existing heating system
I have electric heat and would like to convert to propane or oil
I would like a quote to replace our existing hot water heater

Check your fuel types:
Propane
Oil

What days of the week work best for you? (check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday

What times of day work best for you? (check all that apply)
7:30 - 9:30am
9:30 - 11:30am
12:00 - 2:00pm
2:00 - 4:00pm

Current propane appliances (check all that apply):
Furnace
Boiler
Hot Water Heater
Fireplace
Decorative Heating Stove
Space Heater
Stove
Dryer
Pool Heater
Generator
Other

If other please specify:
Comments / Info:

Customer Information


*First Name:
*Last Name:
*Delivery Address:
*City:
*State:
*Zip:
*Phone:
*E-Mail Address:

Proulx Account Information


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