800-322-8463
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Call Our Customer Service Team at 909-875-3666 for Immediate Assistance
Or, complete the contact form below for assistance.


Please Select Your Service:


Service Requested by:


Telephone:


Extension:



For Onsite Service Calls

Who is the Onsite Contact Person:
Please provide us with the name of a person onsite, if the equipment is not in
the same location as the person requesting service.


Onsite Contact's Phone # & Ext.:


Onsite Contact Location (Dept., Building, Floor, etc.):


Special Instructions for Onsite Work::
Please provide us with any details or important information that the service technician
will need to know or do to perform service at your location. For example, special access
procedures, hours, identification requirements, security rules or concerns, etc.




Ship-In Repair Service

Customer's Return Shipping Address
(Complete only if your are shipping equipment in for repairs / service.
Please provide the complete address for where the equipment is to be
returned once repairs are completed. PLEASE DO NOT PUT THE
BILLING ADDRESS IF THE EQUIPMENT SHOULD BE SHIPPED

Company / Agency Name:


Department:


Street Address:


Street Address, cont.:


City:


State:


Zip:



Customer's Billing Address
(Please provide the complete billing address where all invoices and
receipts are to be sent).

Company / Agency Name:


Department:


Street Address:


Street Address, cont.:


City:


State:


Zip:


Fax Number:


Email Address:


PO# (If applicable):



Time Clock / System Information:
If you have more than one piece of equipment that requires repair / service and / or warranty work, please enter each one
on a separate line and press enter. Please ensure that the make, model and serial numbers are entered in
the correct order for each field. If you do not know the requested information for a particular piece of
equipment, please enter UNKNOWN.


Make(s):


Model(s):


Serial #(s):


What seems to be wrong with equipment or system?:



Service Approval




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