Energy Order Form - Service Hensall Co-op

Energy Services Order Form

Complete this form and submit it online to request Energy Division service.

If you require service on your propane appliance please contact your local contractor. We can assist you with issues with your fuel tanks, hand pumps, propane tanks, underground lines (we do not provide locates), box heaters, piping barns or gas checks.

If you provide an email address, a copy of this form will be sent to you for your records.

* Name
* Mailing address
* Service Address
Email
* Phone number Provide the number we can reach you at during business hours.
Hensall Co-op Account Number if known
Energy Division Service
Requested Date
* Service requested Please provide a description of the service(s) requested.