Repair Request

Please fill out one form for each product type affected. One form for multiple products with the same issue is OK.

Your Details
Name*
First Last
Company Name*
Email*
Phone*
Describe the problem
Affected part:*
Which part is affected?
- Mechanism
- Castors
- Base
- Gaslift
- Arms
- Frame
- Upholstery
- Other
Quantity of products with the same issue*
Please submit separate forms for different product types or separate issues
Upload photos of all issues here and a picture of the complete chair*
Drop files here or

Max. file size: 128 MB.
Detail: (Please describe the problem specifically)*
Hidden
Are the products in a 24hr operation environment?
The following details are on the product ID/care label affixed underneath the seat of the chair
Date of Manufacture:*
DD dot MM dot YYYY
Job number or JS# :*
Chair Model Name and Description:
Where is the product located?
Company Name*
Address*
Site Contact Name*
Site Contact Mobile Number*

Your Details