Damaged-Area | www.surfacesrx.com

Pictures of item

Please use your phone to take pictures of the item(s) you are interested in repairong==n

Your Name *

Email Address *

Phone Number *Please provide us with your mobile phone number

Type of Furniture What piece of Furniture do want to be redesigned and hand-painted

Any Repairs Needed?How do you want your piece of Furniture to look after it is redesigned?

Finish or Look DesiredHow do you want your piece of Furniture to look after it is redesigned?

Ideas & Inspirations Please post some links and or Pinterest Pins/Boards with images of the finish/look that you want

Desired Completion DateWhen would you like to have your piece finished?

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

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