Service Request Form revised

Press enter to begin your search

Home » Service Request Form revised

Service Request

"*" indicates required fields

First Name*

Last Name*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

Mobile Phone*

Store Name*

Serial Number*

Chair Model Number*

Chair Color*

Date of Purchase*

MM slash DD slash YYYY

Do you have an active warranty?*

Please Upload Proof of Purchase*

Max. file size: 512 MB.

Attach Photos or Videos

Drop files here or

Max. file size: 512 MB.

Detailed Description / Error Code

CAPTCHA

Δ

Skip to content

Accessibility Tools