Online Fix-It Request Form

Name

Phone

Email address:

Address

City

Zip Code

Please select the type of work needed (check all that apply)

Grab bar installation
Minor plumbing
Lock/door repair
Drywall repair
Tile repair
Weatherization
Electrical repairs
Energy Kit
Other

Do you have the materials necessary to complete the repairs?

Yes, I have the materials to complete the job.
No, I don't have the materials and would like to discuss my options.

Thank you for contacting CareConnect. Our Fix-It Director will contact you within one business day to discuss your repair needs.