Siksika Health Facilities Maintenance Work Order Request Form

April 24, 2023

Facilities Maintenance Work Order Request Form

Name & Email Contact(Required)

Which Siksika Health facility are you requesting work for?(Required)

Please check only one of the following. Submit a separate form for each work order request.

Siksika Health & Wellness Centre

Head Start Building

Crisis Building

Work Request:(Required)

Please check only one of the following. Submit a separate form for each work request.

Plumbing (sinks, toilets, etc.)

Office Setup (move furniture, hang pictures, etc.)

Landscaping (grass cutting, etc.)

Snow/Ice Removal

Vehicle Maintenance

Equipment/Product Pickup or Delivery (for events only)

Details of Your Request:(Required)

Please include as much detail as possible: approximate location at facility (i.e. which bathroom, office number, parking lot, etc.), which vehicle (make/model), items and location for pickup/delivery, etc.

Deadline(Required)

Please note that Facilities Maintenance Work Order Requests require a minimum 48hrs (2 business days) turnaround allowance. Depending on scope of request, more time may be required. In case of emergency we will get back to you within the hour.