EmailMe Form - J&R Equipment Service Request Form

Name *

First Last

Email *

Phone *

### - ### - ####

Is this a cell, home, or work number? *

We are able to send text messages to confirm service appointments if this is a cell phone number and you would like to receive those messages.

Please enter the address where your equipment is located.

Street Address *

City *

State *

Note: We only offer service to those who have equipment in one of these states.

Postal/Zip Code *

Make

Model

Serial Number

Warranty *

Yes

No

Unsure

Is this unit under a LABOR warranty?

Details of the issues your are experiencing. *

Please describe, to the best of your ability, any details about the issues you are experiencing so that we can better assist.

You can certainly send us a photo if available!