Service Request Form

Service Request Form

Company Name*

Contact Name*

Phone Number

Please enter a number where you can be reached.

Phone

Job Site Address

Contact Email*

WO Number

This number may be located on the RG serial number tag

Model Number

This number may be located on the RG serial number tag

Serial Number

This number may be located on the RG serial number tag

Issue Type*

Select or enter value

Machine Down

Check box if this is a machine down situation

Return for Repair

Check this box if you would like to return the unit to RG for repair.

Field Repair

Check this box if you need service on-site.

Description*

File Upload

Drag and drop files here or

Send me a copy of my responses