Form

To schedule a service repair or pars request, please fill out the form below, and one of our service team members will contact you. If this is an emergency, please contact us at 1-800-872-2532 and ask for Customer Care.

Business Organization*

Are you a customer?*

Primary Contact

First Name*

Last Name*

Email*

Phone Number*

🇺🇸

Quote / Approval / Review Contact

First Name

Last Name

Phone Number

🇺🇸

Request Service Location

Street Address*

City*

State/Region*

Postal Code*

Location Protocol

Additional Location Information

Equipment Information

Make*

Model*

Serial Number*

USAC Equipment Status*

Operational

Out of Service

Under Warranty

I do not need service

Are you aware of any damage or missing parts?

Description of Issue*

Thank you for submitting your equipment information. If you know any additional information to add to your request, please indicate below and our support team will be in touch with you shortly.

Additional Information