Maintenance Request

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APPLICANT INFORMATION

Are you an existing customer?

Referred by:

Contact Person

Phone Number

Email address

Organization

Site name (If different from organization)

Street Address

City

Postal code

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IDENTIFICATION OF THE DEVICES

Number of devices under the current request

1
2 or more

Attached the list of devices under the current request (Type, Manufacturer/Brand, Model, Serial Number and Availability Date)

Excel file type is preferred in order to accelerating the process. Note that the purchase date of your devices under warranty is required. The proof of purchase will be required prior to intervention.

Exemple de fichier Excel à transmettre:

	Nom	Fabricant/Marque	Modèle	# de série (facultatif)	Date de disponibilité
Appareil 1
Appareil 2
...

Pour toutes questions concernant le fichier à transmettre, écrivez-nous à:

service@haelys.com

Other device type:

Manufacturer/Brand

Model

Serial Number

Nature of the work to be done

Availability date of the device

You can attach a photo of your device if you wish:

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OPTIONS OFFERED

Choose the option that is convenient for you:

Onsite maintenance
In workshop maintenance

In case of an onsite maintenance, a technician will contact you to schedule an appointment

Choose the option that is convenient for you in regard of transportation:

We are planning the pick-up for your devices with our own transporter. Additional fees will be applied.
You plan the shipping of your devices.

Office hours from Monday to Friday

Note that pick-up will occured as early as the next business day.

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ADDITIONAL INFORMATION

Comments:

Do you need further information?

A customer service representative will contact you to explain the prices and answer your questions.