Service Guide

Service Guide
Information

Please provide us with some basic information.
Owner's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Who is filling out this form? *

First NameLast Name
I am the equipment owner.A friend or relative is filling out this form for me.An EZ Mobility Solutions staff member is filling this out for me.
StairliftVertical Platform LiftRampElevatorPowered Scooter or WheelchairOther

Yes. I will redo the form when they are here.No. I will need a technician to come out. *We will collect a credit card before coming out*

Action!

Please take the action associated with the question you are on. If that works, you are all set. If not, this form will restart and you can keep trouble shooting.
Yes.No.

Ramp
My ramp bounces as I walk on it.My handrails move when I walk on it.Pieces of my ramp have come off.My ramp is too steep.My ramp has been damaged.Other
Any other notes?

Vertical Platform Lift
YesNo
Yes. Pull out the red knob and try the VPL.No.
No. Turn the key and try the VPL.Yes.
Yes. Remove the items and try the VPL.No.
If the VPL has any lights on, please describe which ones and what color they are.
Please describe what is going on. We will reach out and schedule a service.

Powered Scooter or Wheelchair
What brand is your powered mobility product?
What model is your powered mobility product?
Yes. I moved the lever back to Drive and it's working now.No. It is still not moving or beeping.
My scooter or wheelchair won't move.My scooter or wheelchair is beeping.My scooter or wheelchair won't hold a charge.Other
Drop it off at our shop.Schedule a pick up for $200. We can only pick up within one hour of Roanoke.

Service Acknowledgement and Authorization

(Products not purchased from and installed by EZ Mobility Solutions)
-I understand that EZ Mobility Solutions provides service to non-customers on a time and labor basis, with a $250 non-refundable service call fee, which includes the first hour of service.
-I understand that each additional hour is billed at $100 per hour beyond the initial service call.
-I acknowledge that the $250 service call fee is non-refundable, regardless of whether the unit is repaired.
-I understand that EZ Mobility Solutions does not guarantee that my equipment can be diagnosed or repaired.
- I understand that EZ Mobility Solutions assumes no liability for the performance, condition, or outcome of repairs on equipment not originally sold or installed by them.
-I understand that EZ Mobility Solutions can provide an estimate of labor time and scope of work prior to beginning service, but actual time required may vary.
-I understand that if the unit is operational at the time the technician leaves, the service will be considered complete and the unit considered repaired.
-I acknowledge that no warranties or guarantees are provided on any materials or service performed for non-customers.

Service Acknowledgement and Authorization
- I confirm that I have completed the EZ Mobility troubleshooting guide in full and my device is still not operating properly.
- I understand that the EZ Mobility Warranty covers defects in materials, workmanship, and installation only.
-I understand that batteries are consumable components and that battery failure, loss of charge, or reduced performance is considered normal wear and tear and is not covered under the warranty.
- I understand that if an in-home service visit determines the issue is caused by any condition addressed in the troubleshooting guide (including but not limited to power issues, batteries, user operation, obstructions, or maintenance-related issues), the visit will be classified as a non-warranty service call, and a $150 service fee will apply.
-I understand that if I decline to pay the applicable non-warranty service fee, EZ Mobility Solutions may decline or suspend non-warranty service for this unit until payment is resolved.

Information