This request form is for internal DHPS use only. DHPS SERVICE REQUEST-INTERNAL Property Owner Name Property Owner PhoneContact Name Contact PhoneEmail Job Location(Required) Street Address Description Parish Details of the Service(Required)Please enter the details for this specific job Materials and/or Tools NeededPlease enter the details for the materials and/or tools that will be needed FILE UPLOAD Drop files here or Select files Accepted file types: jpeg, jpg, png, pdf, doc, docx, xls, xlsx, mp4, mp3, Max. file size: 28 MB.
