Form Upload Test | The Cylinder Guy

0800 234 800 South Island: 03 9263670 North Island: 04 9090270

Name*
Email*
Phone (mobile preferred)*
Street No *Auto Populates
Street Name
Suburb
City
Post Code
Are you a:
- New Customer
- Existing or Returning
Is Your Enquiry:
- Extremely Urgent
- Urgent
- ASAP
- Not Urgent
Do you know the age of your system:
You can often find the age of your system on the cylinder itself, date stamped. Also if your house is over 15 years old then it's likely the cylinder is too.
- Less than 15 years old
- More than 15 years old
- Not Certain
Where did you first hear about us?
What is your enquiry about, please select:*
- A New Cylinder
- A New Gas Installation
- A New Heat Pump
- Leaking Cylinder
- No Hot Water
- Constant Overflow
- Current Customer
- Account Query
- Warranty Claim
Would you like to add any other details:
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