Call Us Today
866.676.EMS1
(3671)
Home
SERVICE & REPAIR
Field Service
Transducer Repair & Evaluation
Depot Repairs
System Install & De-install
Tech Support
Sales
System Sales
Transducer Sales
Part Request
Parts Inventory
Service Contracts
Training
About Us
FSR
EMS
CONTACT US
Career Opportunities
Home
SERVICE & REPAIR
Field Service
Transducer Repair & Evaluation
Depot Repairs
System Install & De-install
Tech Support
Sales
System Sales
Transducer Sales
Part Request
Parts Inventory
Service Contracts
Training
About Us
FSR
EMS
CONTACT US
Career Opportunities
Efficient | Reliable
Having issues with your portable? Need repairs in a timely manner? Don't pay for expensive onsite repairs. Send in your portable to Exclusive and we will help reduce your costs by 30-60% compared to OEM prices.
LOANERS UPON AVAILABILITY
FREE EVALUATION
FLAT RATE REPAIR
QUICK TURNAROUND TIME
JavaScript must be enabled to view this content.
Depot Repair Request Form with Loaner
Click Here
×
Repair Request Form
Requester Information
Full Name
Email
Phone Number
Request Date
Company
Equipment Information
Type
-- Select --
Machine
Transducer
Board
Other
Manufacturer
Model Number
Serial Number
Status
-- Select --
Warranty
Repair
If Other, please specify
Repair Details
Problem Description
Error Messages (if any)
Steps to Reproduce the Issue
Has this issue occurred before?
No
Yes
Loaner Equipment Request
I need a loaner device while my equipment is being repaired
No
Yes
Required From
Required Until
Preferred Loaner Type
Any available
Machine
Transducer
Board
Special Requirements
Image Attachments
Upload images of the issue (max 32MB each)
To upload multiple images from a folder,Press the Ctrl+A key combination on your keyboard or While still holding the Ctrl key, click on each additional image you want to upload
No files selected
No files uploaded yet
Shipping Information
Shipping Address
Shipping Contact Name
Shipping Contact Phone
Return shipping address is same as above?
Yes
No
Return Shipping Address
Return Shipping Contact Name
Return Shipping Contact Phone
I confirm that the information provided is accurate and I understand that I may be contacted for additional details.
Yes
Submit Repair Request
Live Chat Support
×
Connecting
Submit
You:
::content::
::agent_name::
::content::
::content::
::content::