Customer Service Form

Customer Service Form

This form is for customers that wish to have the there van serviced either under warranty or out of warranty by the MODCON RV service team

Customer First Name*

Customer Last Name*

Phone Number*

Phone

Email Address*

Street Address*

Address, Suburb, Postcode, State

Type of van*

Select or enter value

Are you the original purchaser of the Van*

Did you buy the camper from MODCON RV Directly

YES

NO

Where was the van purchased from?

Date of Purchase*

Date of collection or handover

Month and Year of van*

Found on the VIN plate of the van next to Manufacture Date

As an example it could say 04-2022

VIN Number*

Found on the VIN plate

Is this for Service or Parts*

Select or enter value

Parts requested

Please attach an image of the parts that you have requested

Description of concern 1*

You must also attach images or videos of concern at the bottom of this form or your claim will not progress

Description of concern 2

You must also attach images or videos of concern at the bottom of this form or your claim will not progress

Description of concern 3

You must also attach images or videos of concern at the bottom of this form or your claim will not progress

Description of concern 4

You must also attach images or videos of concern at the bottom of this form or your claim will not progress

Description of concern 5

You must also attach images or videos of concern at the bottom of this form or your claim will not progress

File Upload*

Drag and drop files here or

I Agree to the below terms and conditions*

By submitting this form you agree to MODCON RV's Warranty statement available to view HERE

By submitting this form, you understand that work not covered by MODCON RV's warranty statement will be billed at an hourly rate viewable in the booking confirmation email.

Version 19/04/2023

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