SERVICE CALL
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Technician Name
*
Your First Name
Your Last Name
Technician E-mail
Your Email
Date & Time Call was received (time stamp on voicemail)
*
-
Month
-
Day
Year
Date
Hour : Minutes Minutes
AM
PM
AM/PM Option
Type of Call Taken
*
Please Select
Service Call Request
Technical Support
Sales
Parts
Other
Customer Company Name (example Amazon ABC3)
*
What state is the Site located in:
*
Please Select
Outside the US
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
If an Amazon site SEV Event Category
*
Please Select
SEV 1
SEV 2
Non-Sev Event
Non-Amazon Site
Initial Contact Customer Name / Tech Name
*
First Name
Last Name
Initial Contact Customer Email
example@example.com
Initial Contact Customer Phone Number
*
Please enter a valid phone number.
Is Site Contact Information different?
Yes
No
Site Contact Name
First Name
Last Name
Site Contact Phone Number
Please enter a valid phone number.
Site Contact Email Address
example@example.com
Jobsite Location
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Product Line
*
Please Select
Flexible Gravity
Flexible Powered (BFP)
Rigid Modular (Best Connect)
Curved Belt
Telescopic (MaxxReach)
Rigid Drive Out
Rigid Two Stage (TL2)
LITESORT
PowerTrax
DeStuffIt
Other
Other Product Description
Service Work Required?
Yes
No
Customer PO#
PO may be required for tech support calls as of Jan 2025.
Dock Door #
Serial Number
Does issue require two technicians?
Yes
No
Unsure
Technician / Third Party Subcontractor Assigned (if 3rd party list tech and Company)
Who have you dispatched?
Regional Service Manager for this Area:
This field is auto generated.
Date of Scheduled Service if Applicable
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Case and WO # (If applicable )
Only CSRs will enter data to this field.
System Issue and Resolution / dispatch notes
*
Be very descriptive.
Comments
*
Photos of Issue
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