Customer Repair / Cleaning / Calibration Form

Please complete this form to request repair, cleaning or calibration services from Paragon.

* Red fields are required.

Contact Information:

Name:
Company:
Address:
City:
State / Province:
Country:
Postal Code:
Phone Number:
Fax Number:
E-mail Address:

* Note: If you purchased this item from Paragon please provide date, invoice number and Paragon Rep.

Purchase Date:
Invoice SO:
Paragon Sales Rep:

Manufacturer:
Part Number:
Serial Number:

* Note: Please list any accessories you will be sending in with this unit.

Included Accessories:

Please provide a brief description of the service you are requesting and any known issues with the unit.

Service Request:

Upon receiving this form, a Paragon Repair Specialist will be contacting you.

* Note: Please wait for further instructions before sending anything to Paragon. Thank You.

I understand and accept, Paragon's "Repair / Cleaning / Calibration Terms".

* Validation Code is Thu5424 , Please enter it in the field provided.

Validation Code:

Privacy Statement: Paragon respects the privacy of all individuals and will not sell, lease or rent your information to any entity at any time.