Malfunctioning Product Reporting Form

If you have experienced a technical issue, in the field, with a Raypak boiler or water heater and you feel the issue should have been caught at the Factory, please use this form and provide all of the requested information.

"To Save Time, Take Your Photos First Before Starting Form"

Your Contact Info

First Name

Last Name

Email Address

Company Name

Tell Us About The Problem You Experienced

Date of Issue

Product Type

What City Is The Equipment Located In?

What State Is the Equipment Located In?

Name of Distributor Product Was Purchased From?

Product Serial Number

Please Provide Details Of the Field Issue

To Be Considered For Review, The Following Photos Must be Included:

1. Photo of the Rating Plate 2. Photo of the Relevant Issue 3. Image of the Boiler Install 4. Any Relevant Document

Attach Photos/Images or Documentation Here

Drop your files here

Resolution/Solution

RSM

Send me a copy of my responses

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