Order Carpet Online from Unique Flooring Services in Denver Colorado

Order Form:

Are you a current customer?

Yes No

If No, Please provide all contact information:

Contact Information:

Contact Name:

Company Name:

Address 1:

Address 2:

City, State, Zip Code:

Primary Phone Number:

Secondary Phone Number:

Fax Number:

Email Address:

Property Information:

(enter "same" if same as Contact info)

Property Name:

Property Address 1:

Property Address 2:

Property City, State, and Zip Code:

Unit Number:

Unit Size:

Unit Status:Vacant Occupied

*Furniture to Move? Yes No

Requested Installation Date:

Services Requested:

Carpet:

Complete Partial None

*If you select "partial" please indicate which areas or rooms in the "Additional Information" box below.

*If you prefer more than one carpet type or color in the same unit, please indicate which areas or rooms in the "Additional Information" box below.

What style / color carpet do you want?
Select one carpet option from the list:

Pad:

Complete Partial None

*If you select "partial" please indicate which areas or rooms in the "Additional Information" box below.

*If you prefer more than one pad quality in the same unit, please indicate which areas or rooms in the "Additional Information" box below.

What type of pad do you want?
Select one pad option from the list:

Vinyl:

Complete Partial None

*If you select "partial" please indicate which areas or rooms in the "Additional Information" box below.

*If you prefer more than one vinyl type or pattern in the same unit, please indicate which areas or rooms in the "Additional Information" box below.

What type of vinyl flooring do you want?
Select one or more vinyl options from the list:

Additional Information:

*	Is there a lock box on the Unit?	Yes No If Yes, Code:
	NOTE: Although relatively safe, the lockbox code is not encrypted and cannot be guaranteed 100% secure. If you omit the code, please call our office and provide it verbally.

	Additional Information, Details, or Questions:

	You MUST press the "SUBMIT" Button below or we will not receive your order. You may wish to print this page before submitting.
	For MULTIPLE orders, submit and then use your browser's BACK button to return to this form. Then change only the fields needed for the additional order(s).

Carpet · Vinyl · Quality Installations

Order Form