Service / Sales / Supplies Form
Please select ONSITE SERVICE or SHOP SERVICE:
*
On-Site Service
Shop Service / Carry In Service
Order Supplies
Sales Call
UID
PLEASE NOTE, SHOP SERVICE has a $45 Diagnostic Fee that will be applied to your total cost if approved. (Non-Refundable)
Company Name (Optional)
Preferred Hours of Service
Name
*
First Name
Last Name
Mobile: (Please note this is not for solictations. You will only receive text messages related to this service call
*
Please enter a valid phone number.
Email:
*
example@example.com
Equipment:
Copier / MFP
Printer / Fax
Computer
Laptop
Shredder
Other
Make & Model
*
Problem Reported
*
Brief description of the problem you are having with equipment
Supplies Needed
*
Brief description of supplies needed
Sales Request
*
Brief description of reason of sales call
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If convenient, please take a photo of equipment.
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$45.00 Diagnostic Charge
Non-Refundable Diagnostic Charge
$
45.00
Credit Card
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