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Name:
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Job Detail
Which reglazing service do you require?
Reglaze Bath:
Reglaze Shower Tray:
Reglaze Basin/Vanity:
Reglaze Spa Bath:
Reglaze Wall Tiles:
Reglaze Complete Bathroom:
Chip Repair Only:
Damage Repair Only:
Bath Details:
What Type of Bath do you Have:
Built in Standard Bath
Free Standing (on feet)
Free Standing (no feet)
Corner Bath
Spa Bath
Shower Bath
Has your bath been Reglazed before:
Yes
No
Flaking enamel
Staining
Worn enamel
Don't know
Condition of your bath and tiles
Any holes
Any chips
Any rust (check around taps)
Grout - good condition
Grout- average condition
Grout- poor condition
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