Request Service

 
1 Start 2 Complete

Use this automated form to request service from Lakeland Disposal. Complete the form below with your information and desired collection start date. Submit the form to us by clicking the "Submit" button at the bottom of the page. Every customer is important to us and we will contact you soon as possible! For even faster service, contact us at 715-358-8500!

Contact Information
Business Name (if applicable)
First Name (Required)
MI
Last Name (Required)
Home Phone (Required)
Mobile Phone
Service Address Information
Service Address (Required)
City (Required)
State
Zip Code
What Service and Start Date Would You Like
Desired Service (Required)
Desired Package (See Package Options or leave blank)
Desired Service Start Date
Existing Contract Information
If you have an existing service provider, please specify who that provider is
When does your contract end?
Billing Address (If Different Than Home Address)
Billing Address
City
State
Zip Code
Comments/Questions
Please enter any additional comments or questions
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