Service Request

Furniture Service Request
Name*

First NameLast Name
Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Phone*

Area CodePhone Number
Secondary Phone

Area CodePhone Number
Boulevard Account #
E-mail*
Was your furniture purchased at the Boulevard?*

YesNo
If no, where was it purchased and when?
Brand In Need Of Service?*
La Z Boy ACK # ?
Please Upload pictures of damage, product tags.

Upload a File

Cancelof
What is the item that needs service?
Please describe the issue.
Is there anything else you think we should know?
Should be Empty: