Service Request
Submitted By
First Name
Last Name
Submitted By
*
First and Last Name
Entered on Behalf of
This field is not required to complete if you are the actual client requiring service (above)
Client Phone #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Client Email
example@example.com
Client Email Address
*
Email of Where the Invoice Should Be Sent
example@example.com
Email of Where to Send the Invoice
Company/Customer Name
*
Original Order #/Manufacturer
Service Address
Service Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Service Location In Building
Location in Building where service is needed (Example: 3rd Fl, Don's Office)
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Product/Service Information
Were These Products Purchased From Circadia (Formerly Color Art)
*
Please Select
Yes
No
Unknown
Service Requested For
Assessment Only
Chair/Recliner
Desk/Table
Lighting/Electrical
Non-Warranty Repair
Order Parts
Sofa/Lounge Furniture
Systems Furniture
Warranty Repair
Other
Quantity of Items Needing Service
*
Please Describe Repairs Needed
(Example: Fix Height Adjustment on Chair)
Product Manufacturers
Please separate with commas
Upload PRODUCT TAG Photos Here
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Product Tag typically lists Manufacturer, Model #, Finishes, and Order #. You can find Product Tags under the seat (chairs), on extended foot rails (recliners), under the worksurface (tables/desks), or drawer sides and walls (storage and shelving) Manufacturers require photos of tags and damages to process warranty claims
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Upload CLOSE UP OF DAMAGE Photos Here
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PLEASE ATTACH PICS OF DAMAGED ITEM(S) INCLUDING ANY/ALL TAGS ATTACHED TO THE ITEM Manufacturers require photos of tags and damages to process warranty claims
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Upload PHOTO OF ENTIRE DAMAGE Here
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Manufacturers require photos of tags and damages to process warranty claims
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Any Parts and/or labor not covered by Manufacturer's warranty will be invoiced directly to the client ($70/hr during normal business hours), including the cost of the initial assessment
*
I agree
Source
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Chat
Email
Form
Jotform Submission
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Phone
Website
Number
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