Contact Information:

Service Requested:

Your Equipment:

Request Service

Please use this convenient form to request service for your heating or cooling equipment, or you can call us at (203) 756-7041. We will contact you to confirm the day and time of your service.

* = Required Field

* Name:
(First, MI, Last)

Mr. Ms. Mrs.

Wesson Energy Account Number:

* Address:
(City, State, ZIP)

* Phone:

() -

Work:

() -

Cell:

() -

* Email:

Best Time to Call:

[ Or, please respond via E-mail. ]

Repair (Non-Emergency)
Tune-up (Preventive maintenance)
Equipment Upgrade Estimate
Tank Removal/Replacement Estimate
Other

Please elaborate and provide desired dates and times:

I am currently enrolled in a Service Plan with Wesson Energy:

Yes No

Age
(in years)

Details

Oil Furnace

Oil Boiler

Oil Burner

I have the following in my home (click all that apply):

Type of Domestic
Hot Water Heater:

Oil Gas Electric

Please correctly type in the following phrase to verify:
Please type e.n.e.r.g.y. without the periods in the box to the right.