When entering a request for service, please give us your name, telephone number and any internal tracking number such as a "Heat Ticket" number. Then complete both sections, Billing Information and Service Location. Completing both sections will insure that your service experience will be handled in the quickest and most efficient way possible.

Your Name:*
Your Phone:*
Your Email:*
Your Tracking Number:

Billing Address: Please enter the mailing address and person responsible for payables at your company. If your company has already established an account with CCR, simply enter your company name on the first line, and "SA" or "MEP" on the second line. Your may then skip all other entries in this section.

Service Address: It is important that you give us as much information as possible regarding the equipment needing service. If the contact name, address and telephone numbers are the same as in the "billing address" you may enter "same" in those fields. Brand, model, serial number, user name, user's telephone number and location fields are mandatory.

Billing Address:

Service Address:

Company Name:*

Contact:

Address:

City:

State:

Zip Code:

Phone:

Company Name:

User Name:*

Floor/Dept:*

Address:

City:

State:

Zip Code:

Phone:*

Item for repair:*
Unit Serial Number:*
Use this box to give us information about
your problem and any questions you might have:*

When you are finished . click Submit.
If you would like to start over, click Clear.

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