Panasonic Only For Commercial Service go to commercial products. For other brands use this form.

 
Product Brand
Product Type
Model Number
Serial Number
Custom Install Note:     

We will not remove flat screens from the wall (especially over the fireplace) or from inside custom enclosures or furniture as part of the repair service. If you cannot have the product placed in a service ready position, we will be happy to give you a quote for additional help and/or trained installers. Wall mounts and custom cabinetry requires a signed release.
Display or TV Size (Inches) < 31" (Out of Warranty-Carry-In Service only)
Does not apply to Plasma 31-36 Standard Direct View  *
31-36 HD (Wide Aspect Ratio) Direct View *
36-40 Projection, LCD or DLP
42-50 Projection, LCD or DLP
> 50" Projection, LCD or DLP *
*  Always requires 2nd man service for safety. 
Additional charges per-man apply.

 
Best Day To Schedule
Best Time of Day
Note:       Day and times are preferences. They are not guaranteed.
     

Method of Payment - Please Select Only One

Cash or Check
  Credit card We will get your credit card information when we schedule your service call
   
  Warranty Only these Manufacturers for Warranty Service.
Date of Purchase
Dealer Name
  Extended Service Plan (ESP)

Only those plans in  drop-down list !


If your service contract company is
not in the drop down list ...
Plan/Contract Number
Expiration Date

 

Your LAST name
Your FIRST name
Address

City
State
Zip Code
   
Home Telephone
Work Telephone
Cell or Pager
E-Mail Address
Note: If you do not provide a valid email address,
we may be unable to contact you.

  COMPLAINT or SYMPTOM
    



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