Before we do any work we will contact you further to: 

confirm receipt of your request
make payment arrangements if applicable
obtain additional information
schedule a service call

*Company
*First Name
*Last Name
*Phone Number	()
*Email Address
*Address
*City
*State	Select a State N/A Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Ontario Quebec Nova Scotia New Brunswick Manitoba British Columbia Prince Edward Island Saskatchewan Alberta Newfoundland and Labrador Armed Forces - AE Armed Forces - AP Armed Forces - AA
*Are you reporting a chair problem	Yes No
If Chair, what is the problem?	Arms (broken, malfunctioning) Seat (broken, malfunctioning) Pneumatic (height adjustment mechanism) Other/Describe (example soiled upholstery)
If not, what type of furniture is involved?	Desk Table Light File or Drawer Lock or Key Electrical Components
Please take a moment to inspect your furniture for a manufacturer's tag. Typically, they are found in a bottom drawer, underneath the top cap on a panel, or underneath a work surface. Please list all information on this tag:
*Manufacturer	(ex. abcd)
Model or Part Number	(ex. abcd)
Date of manufacture	(ex. abcd)
*Please describe the problem(s)
*Did you purchase this furniture new?	Yes No
Who is your Storr OE sales rep or primary contact?	(ex. abcd)
*Required Fields