Terry Adams
fax 912.920.0141

JCW Quality Rentals Service Request Form
Thank you for letting us know of a problem you are having that may need service and attention from our maintenance department.

We take pride in the quality and condition of the homes we rent, but occasionally something goes wrong or accidents happen. We expect and want you to contact us immediately so that we can assess the situation and take action as soon as possible, if needed.

Fill in the appropriate information on the form below and follow the prompts to submit your request. You will receive an e-mail acknowledgement that your service request was received, and you will be contacted within 48 hours after submission of your request.

Submitting this form online means we will be immediately aware of your service request and that a written record exists for both you and us of the date and time of your request. We ask that you make use of this online Service Request Form whenever possible.

EMERGENCY? Call 911 for health and safety issues. Please place an online service request and be sure to include your name, phone number and description of the maintenance issue. 
Required Field

  * Your Name

   * Name of Person on Rental Agreement (if different)

   * E-Mail Address

   * Primary Phone                                 Secondary Phone

   * Best Time to Call

   Name of Your Subdivision/Community (if applicable)

   * Street Address                                                Apt. #

   City                                            State

   * Give brief description of items(s) of concern:

   Room(s) or location(s) for item(s) of concern:


Secure Code:





 © 2018 Agent Image All rights reserved. | Terms | Sitemap Design by Agent Image - Real Estate Web Site Design