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712-722-1700
877-722-1770

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care@promisechc.org

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33 4th St NW,
Sioux Center, IA

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MAINTENANCE

HomeMAINTENANCE

Do NOT fill out form if this task is an EMERGENCY. Please contact Rebecca or a member of the leadership team if you have a Maintenance Emergency!

MAINTENANCE FORM

Please fill out this form if you require maintenance.

Maintenance Form Contact Name*
Maintenance Area - be specific which hall, room, office or area*
Maintenance Task*
- I have a repair task
- I have a moving task
Maintenance Task Date Request*
- Please add to the list for when our repair man comes again
- Please have this task before the date below (please give explantation of why task needs to be completed before date)
Requested Date of completion and explanation
Give more details and information about exactly what maintenance you chose above - give plenty of info so if maintenance man comes when you are not here, he can still resolve the issue*

33 4th St NW, Sioux Center, IA 51250
Phone: 712-722-1700
Fax: 712-722-1770
Email: care@promisechc.org

PROMISE NEWS

NATIONAL RURAL HEALTH DAY 2020
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MEET PROMISE BABY: FRANCESCA JADE
Nov 09
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This health center receives HHS funding and has Federal Public Health Service deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.

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