What is the address for the pickup being requested? If the items are in a common area or parking area, please provide the address of the nearest unit or cross street. Patriot must have this information in order to schedule a pickup.

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What is the address for the pickup being requested? If the items are in a common area or parking area, please provide the address of the nearest unit or cross street. Patriot must have this information in order to schedule a pickup.

Please provide an email address for confirmation of your pickup request.

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Please provide an email address for confirmation of your pickup request.

Please provide a list of all items to be collected (i.e., types of furniture, appliances, number of bags or boxes, etc.). Patriot must provide this information in order to schedule a pickup.

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Please provide a list of all items to be collected (i.e., types of furniture, appliances, number of bags or boxes, etc.). Patriot must provide this information in order to schedule a pickup.

Do any of the items contain Freon or other type of refrigerant (ex., A/C units, fridges, freezers, wine coolers, etc. - regardless of size or working condition)?

Do any of the items contain Freon or other type of refrigerant (ex., A/C units, fridges, freezers, wine coolers, etc. - regardless of size or working condition)?(Select an Answer) Yes No

If requesting a pickup for an appliance containing refrigerants, has the Freon or other type of refrigerant been removed by a licensed technician who has tagged the unit stating this service has been performed?  Please note - if this has not been done and there is no tag on the unit, Patriot will not collect these items.

If requesting a pickup for an appliance containing refrigerants, has the Freon or other type of refrigerant been removed by a licensed technician who has tagged the unit stating this service has been performed? Please note - if this has not been done and there is no tag on the unit, Patriot will not collect these items.(Select an Answer) Yes No Not Applicable

Please note that your pickup is not confirmed until you have receive a response from Patriot's customer service team verifying the date of your pickup and providing additional set-out instructions. Please DO NOT put bulk items out until you are added to the bulk item pickup schedule. Once you have received an email from Patriot, then bulk items may be set out at the curb any time after 4:00 p.m. the day prior to collection.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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