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This document is a work order request form. It has sections for:

  • Requestor information: Name, phone number, and email
  • Request details: Date of request, location (address, building, room number, affected equipment/asset/system)
  • Request description
  • Type of issue (with checkboxes for automotive, grounds, plumbing, custodial, HVAC, security, furniture, painting, electrical, pest control, safety, and an “other” field)
  • Best times for service and Desired completion date
  • Urgency (low, medium, high checkboxes)
  • For use by maintenance department: Accepted by, date, and assigned work order number.

The templates available in the FMX Checklist & Template Library have been created by our customers and employees to help get you started using FMX's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace, jurisdiction, and individual circumstances.

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