Create Service Request

Create Service Request Form

To create a service request for your device, please enter the following details or call us at 1-800-355-1385.

Please Note: Service calls placed after 5:00pm local time, will be placed in the queue for the next business day.

* Indicates required fields

Device Information

Serial Number: DFH24222
Equipment Number: DFH24222
Model: IR3225
Install Location: 7600 MARKET ST ,YOUNGSTOWN, OH - 44512-6078
Do you want to select a different Install Location?:
* Room/Floor/Suite:
* Business Hours: To:

Contact Information

* Contact Name:
* Contact Phone:

Billing Information

I understand that service will be billable and am authorized to approve payment?
Bill To Location:
Payment Method:
P.O. Number or First/Last Name:

Service Request Information

* Problem Summary:
* Problem Description:
Additional Instructions: (100 characters only)