Chim-Scan Repair Form

Chim-Scan Repair Form
IF your the Office Manager or Warehouse Manager and have no idea what to send. We're here to help you, so feel free to reach out, before you send us stuff. Send an email to info@chimscan.net or esther@chimscan.net Or Text 641-472-7643 - Tell us who you work for and what the guys dropped on your desk. A picture or video are also welcome.
Name (Your Name)*

First NameLast Name
Company Name*
Company Owners Name (If that's not you) *

First NameLast Name
E-mail (Your email or the person we need to talk to about the repair coming back email)*
We don't sell or share info.
Name #2 (If you work with a franchise, please give us the name of the person who pays the bills and their email)

First NameLast Name
Email #2 (If you work with a franchise, please give us the name of the person who pays the bills and their email)
example@example.com
Phone Number (Your number)*
Please list office phone or cell phone
Office/ Who we should talk to about repair - Phone Number *
Please enter a valid phone number.
Date - you shipped the repair

MonthDayYear
Date - you filled out form - if different from ship date

MonthDayYear
Date
Chim-Scan® Serial # Or Name you use - List both if possilbe.
This will be located under the unit's handle and in your manual.
Why do we want to know all of this?

Because it can take up to four business days (depending on your location and how you send it) for your unit to arrive here, this form acts as a packing list for us, so should the box be damaged, we can verify we have everything you sent. Also, this form helps us know who sent the unit and where we need to send it back to; shipping tags don't always give us the information we need.
Preferred Shipping Method for us to send your unit back*

UPSUSPS - Mail
SHIPPING Address: *

Street Address

Street Address Line 2

CityState

Zip Code
Billing Address (if different from shipping)

Street Address

Street Address Line 2

CityState

Zip Code
Has the company changed location in the last two years?

YesNoI don't knowYes and I listed the new address
**If you want us to ship the repair back to you with UPS - we ship Ground unless you request faster shipping. NOTE: 3rd, 2nd, and Next day shipping are expensive.

Ground is fine3 day - (only useful if you live in NJ, DE, CT, VT, NH,ME,AZ,NV,OR,CA,WA,ID)2nd Day2nd Day - Early AM - 10am - (Usually double the cost of ground)Next Day - (is always over $120)Next Day - early AM - 10am - (Always over $150)
Tell us what's going on, what happened, what it's not doing, or what it's doing, which it's not supposed to do.*
PLEASE send us a photo of what you're sending. You can text the photo or video to 641-472-7643 - please include your name and company name.

This helps us to check that what you sent wasn't damaged in shipping. PLEASE give our number to your tech's so they can send us photos or videos while in the field. We may be able to help before your send it back.
Send us a Photo of the broken part. If you've sent a text you can skip this
Upgrades / Updates - make sure you look at the upgrade page on the website page Equipment Upgrades under Current Customers(chimscan.net)

No, Just fix itNot right now, but send info on what can be doneI'm open to updating/upgrading the unit, but want info before I decideI saw an email about upgrading/updating
THIS IS IMPORTANT please read subtitle
How does this help you??

By filling this out, you not only help us, but you help your office staff (even if you are the office staff) what needs to go, what you were sending when you sent it, and why you're sending it. If you keep a copy of this, you can track how often you're sending a unit or units back for repair and what needs to be repaired. This way, if you notice you're always sending a cable back for the repair, you can track down the cause.
What are you sending??

Whole Unit - Controller, Camera, Cable, and CaseJust the Controller (Part with switches that control camera)Just the CameraJust the CableController and a CameraCamera and CableMultiple Cameras - please wrap each camera separatelyMultiple CablesMultiple Whole Units - Please Ship in separate boxes, damage is more likely if units are packed together.No Clue / Not Really Sure
If sending a Controller or Whole Unit - what series or model is it

Model 405, 500, or 402Series 100Series 200 or 210Series 300Series 250 or 275Series 211I have no idea
What type of Image/Video recorder does the unit have

NO CLUENoneSD RecorderCF or Compact FlashMavicap / Floppy DiskVCRDVDPolaroid Camera - was new in 1980Combo of 2 or more listed
What type of Camera

I have no clueAuto Focus (built 1989 - 2001)Auto Focus Tilt / AFT ("Brick that moves', could Zoom (built between 1997-2012))Enviro in a Cheesehead or Cheesebit bracket (1999 - Today)Cheesehead Auto Focus Camera / CAF (built between 2000- 2012)J3D Camera - No TiltJ3D Camera with TiltLighthouse Tilt ((Works like Lighthouse but can tilt up and down) Started to be built DEC 2020)Lighthouse Camera (aka the tower or pole camera (Started being built in 2013))Tilt Combo Camera / LHTC (is two cameras, one that looks up and the other at 90° with tilt ability (Up camera is Enviro and 90°with tilt is Lighthouse Tilt))Combo Camera / LHC (is two cameras, one that looks up and the other at 90° (Up camera is Enviro and 90° or side view is Lighthouse))3" Round Camera (built between 1990-1999)Cube Shaped Camera (built between 1987-1999)Rectangle Shaped Camera (Brick on a stick, the original Chim-Scan camera)Mini- Enviro Camera
IF your the Office Manager or Warehouse Manager and have no idea what to send. No worries. Send an email to info@chimscan.net or esther@chimscan.net Or Text 641-472-7643 - Tell us who you work for and what the guys dropped on your desk. A picture or video are also welcome. We're here to help you, so feel free to reach out.
NOTE : Call Tags are getting more expensive! So to save yourself some $$ please look into going to UPS.com or FedEx.com and creating a tag for yourself. PLEASE READ the Note we've put for taking it to a Pack 'n Ship store as those suggestions hold true for getting a tag from either UPS or FedEx. IF you need packing suggestions, please contact us. PLEASE make sure anything you send is in a size appropriate box and has some form of packing.
Do you need a Call Tag sent to you, or will you be shipping the unit yourself?*

I need a call tagI'm taking it to a Pack 'n Ship store (Side note - Don't insure a package for over $2,000.00, even if you are sending a whole unit. Insure over $2,000 automatically raises the shipping price by $100 for every $1,000 over $2,000)I have a question on what I should shipI have the repair all boxed up and I need the address - Estoban Corporation 1643 Old Hwy 34, Fairfield, IA 52556
PLEASE get and keep the tracking number for any package you send us.
Should be Empty:

Chim-Scan Repair Form

Why do we want to know all of this?

PLEASE send us a photo of what you're sending. You can text the photo or video to 641-472-7643 - please include your name and company name.

THIS IS IMPORTANT please read subtitle

How does this help you??

PLEASE get and keep the tracking number for any package you send us.