Maintenance Request Checklist
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This Template was installed 3 times.
Requestor Information
Details about the person submitting the maintenance request.
Requestor Name
Requestor Phone Number
Requestor Email Address
Unit/Apartment Number (if applicable)
Date of Request
Preferred Contact Time (Optional)
Relationship to Property (Owner/Tenant/Guest)
Property Information
Information identifying the specific property requiring maintenance.
Property Address
Unit/Apartment Number
Property Type
Building Name (if applicable)
Date of Occupancy (for reference)
Lease Agreement ID (if applicable)
Issue Description
A detailed explanation of the maintenance issue.
Detailed Description of the Issue
Approximate Size of Affected Area (e.g., square feet)
Which of the following best describe the issue?
Specific Details or Circumstances Related to the Issue (e.g., when does it occur, what triggers it?)
Upload Photos or Videos of the Issue (Optional but Recommended)
Precise Location of the Issue within the Property (e.g., Master Bathroom, 2nd Floor Hallway)
Severity & Urgency
Assessment of the issue's impact and the required response time.
Severity Level
Urgency
Estimated Impact Score (1-10)
Briefly Explain Urgency Justification
Desired Completion Date (if applicable)
Initial Assessment & Diagnosis (Technician)
Notes and findings from the technician's initial inspection. (For internal use)
Detailed Description of Observed Issue
Temperature Reading (if applicable)
Possible Cause (Initial Assessment)
Affected Systems (Check all that apply)
Photos/Videos of Issue (Optional)
Estimated Time to Complete (Hours)
Date of Assessment
Time of Assessment
Precise Location of Issue
Work Performed & Materials Used (Technician)
Record of the tasks completed and the materials consumed. (For internal use)
Detailed Description of Work Performed
Trade(s) Involved (e.g., Plumbing, Electrical, Carpentry)
Labor Hours Spent
Estimated Labor Hours (if different from actual)
Materials Used – Description and Quantity
Cost of Materials
Photos of Work Completed (Before & After)
Any Unexpected Issues Encountered?
Details of Unexpected Issues (If Applicable)
Resolution & Verification
Confirmation that the issue is resolved and the requester is satisfied.
Was the issue resolved to your satisfaction?
If no or partially resolved, please explain:
Are there any remaining concerns?
If yes, please describe any remaining concerns:
Date of Verification
Requester Signature (Verification)
Documentation & Sign-off
Final documentation, photos, and signatures confirming completion of the maintenance request.
Technician Signature (Confirmation of Work)
Requestor Signature (Confirmation of Resolution)
Date of Completion
Photos/Videos of Completed Work (Optional)
Overall Satisfaction Level
Additional Comments or Notes (Optional)
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