Blue Ridge Medical Center - Main Campus
MAINTENANCE REQUEST
Task Type
[Please Select One]
mini splits filters
Security
Electrical / Lighting
Equipment Repairs
Fire Safety
Health & Safety
Heating / Cooling
Housekeeping
Mechanical Lifts
Painting / Touch Ups
Pest Control
Plumbing
General Maintenance
Building Area
[Please Select One]
1st Floor
2nd Floor
BRMC Amherst
BRMC Appomattox
BRMC CLINIC
BRMC Dental
Pharmacy
Room#
Details
Your Name
Your Email Address
Submit
Reset
MAINTENANCE REQUEST CONFIRMATION
Thank You For Your Submission.
MAINTENANCE REQUEST ERROR
The request can't be recorded at this time!
!
Possible Duplicate Task
We have identified possible duplicate tasks already submitted in the system.
Date Created:
{date_created}
Type:
{type}
Area:
{area}
Room:
{room}
Comments:
{comments}
File Upload
Add files...
Cancel upload
Delete
×
Upload Error
