Customer Care Support Form
Company
*
Adress
*
Contact Person
*
E-mail
*
Phone
*
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Scope
Scope of the issue
*
The problem is on one single device
This is a general problem
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Product information
Internal Machine Number
*
Product Name/Model
*
Installation Date
-
Month
-
Day
Year
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Issue description + extra information
Please describe the issue in as much detail as possible e.g. what is the behiavior of the device
*
Photos or Videos (if possible)
Browse Files
Cancel
of
Your link to the live portal event
What time did the event occur?
*
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Requested Action (only applicable for hardware issues)
Replacement
Repair
Return
Inspection
Other
Requested Level of Intervention (only applicable for hardware issues)
Level 1: issue resolved according to availability (on avg 5 working days)
Level 2: issue resolved within 3 working days (only possible in BE & NL)
Level 3: issue resolved within 1 working day (only possible in BE & NL)
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