Amendment / Repair Form

How Can We Help?

Please complete this form to request a repair or amendment with Furniture Rentals, Inc.

Repair Request: If any of your rented items need to be replaced or fixed due to damage or a malfunction, Furniture Rentals will replace the item at no charge.

Amendment Request: If you wish to amend your original agreement by adding items after your initial delivery, Furniture Rentals will add the requested item(s) to your rental and will confirm the delivery date/time with you prior to delivery. There is a 4 month minimum on any items added after your initial delivery. An amendment fee will be charged to your account equal to the amount of your original delivery/setup fee.

Is this an Amendment or Repair Request? *

Amendments will incur additional fees/ rate changes. Repairs will not incur any additional fees/ rate changes.

Name on the account *

Address *

City *

State *

Zip *

Apartment Community (if applicable)

Unit Number

Date Requested for Amendment/Repair *

Month

Day

Year

* Amendments/Repairs must be scheduled on a weekday.
** Please make sure all personal belongings are removed from inside and/or on top of the furniture before pick-up is scheduled. Furniture Rentals, Inc. will not pick up any items with personal belongings in or on it.
*** This date is a request. Furniture Rentals, Inc. will confirm the amendment/repair date with you prior to scheduling.

Repair or Amendment Request Description

Please include all available details.

Image Uploads

Upload images of of items requiring amendments/repairs

Upload Photo 1

Files must be less than 8 MB.
Allowed file types: jpg jpeg png.

Upload Photo 2

Files must be less than 8 MB.
Allowed file types: jpg jpeg png.

Upload Photo 3

Files must be less than 8 MB.
Allowed file types: jpg jpeg png.

Upload Photo 4

Files must be less than 8 MB.
Allowed file types: jpg jpeg png.

Is this request urgent? *

Email Address *

Electronic Signature

Attachment	Size
PDF Version	398.96 KB

How Can We Help?

Serving the Southeast from 4 locations