Enter your email address below to join our monthly mailing list.
First Name
Last Name
E-Mail
For residential work we can only serve NYC five boroughs, Westchester, Nassau and Suffolk counties. Bathtub Doctor services NJ and CT for
commercial accounts
only.
Service Inquiry Form
Welcome and thanks for your interest. In order to provide you with the best possible service please provide as much information as necessary. Make sure to include a valid e-mail address and preferred contact telephone number, without them we won't be able to reach you as fast as we can. Thanks again from the Bathtub Doctor team.
Your Information
* = required information
*
First Name:
*
Last Name:
*
Title:
*
Company Name:
*
Job Type :
Please Select One
Residental
Commercial
*
How you heard about us:
* ie. Yahoo search
*
Phone:
* ie. 555-555-5555
Fax:
*
E-mail Address:
*
Address:
*
City:
*
State:
Choose a State
Connecticut
New Jersey
New York
The job site must be in the tri-state (NY, NJ, CT) area to be able to fill-out this form
*
Zip:
(Zip or Zip+4 format)
*
# Units under management:
Please Select One
1 or less
10 or less
25 or less
50 or less
100 or less
250 or less
500 or less
1000 or less
5000 or less
Reglazed before?
*
Looking to have work done:
Please Select One
We are remodeling now
In the next 30 days
In the next 90 days
In 6 months
In the next 12 months
Comments:
*
Type:
Please Select One
Bathtub Reglazing
Wall tile reglazing
Sign me up for the Bathtub Doctor newsletter
(Tell your friends and associates, qualify for 10% rebate!)
Affiliate Program
Signup Here
Privacy Policy
Nass.Lic. # HO301730000
Suffolk Lic. #26,664-HI
NYC #1198785
Westchester # WC-17797-H06
Need proof of insurance? Download our "Request for Information Form"
here
HOME
-
ABOUT US
-
SERVICES
-
FAQ'S
-
ADVERTISE
-
OPPORTUNITIES
-
LINKS
-
TESTIMONIALS
-
CONTACT US
BATHROOM REMODELING
-
BATHTUB REGLAZING
-
CLAWFOOT BATHTUB REFINISHING
-
BATHROOM RENOVATION
