Maintenance / Repair Request Form

Name: Yipirinya School
Price range: $

Use this form to report repair or maintenance needs

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This field is for validation purposes and should be left unchanged.

Employee Name(Required)

First Last

Phone

Department / Area

Line Manager Name

Building/Machine/Vehicle/Asset/Other Type and Description

Building/Machine/Vehicle/Asset/Other Exact Location (if applicable)

Describe FULLY the maintenance need / repair request:

Has the Line Manager in that area been notified of the maintenance or repair need?(Required)

Yes

Is the repair request?(Required)

Critical (affecting everyone and urgent response is required)

Moderate (affects you and perhaps a few others and response is required within the next 48 hours)

Aesthetic (has minimal impact but needs attending to in due course)

Is the maintenance or repair request due to an accident or safety concern?(Required)

Yes

If Yes, an Incident Report needs to be completed. Download the Incident Report

Attachments

Include any photographs of the issue reported

Drop files here or

Accepted file types: jpg, gif, png, pdf, heic, jpeg, Max. file size: 64 MB, Max. files: 5.