Request Service for Your Water Treatment SystemWhether you need salt, a filter change, or service fill out the form below and we’ll contact you to schedule your service appointment.How Can We Help?* Need Salt Delivered Before Next Scheduled Date Filter Change Service Call Other (please explain)Do You Own a Gaines Softwater System?YesNoUnsureWhich best describes you...*Current or Past Gaines Softwater CustomerNew to Gaines SoftwaterAccount NumberName* First Last Phone*Email* Address Street Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Description of problem:*EmailThis field is for validation purposes and should be left unchanged.
