Request a Repair | We Can Fix It | Advanta

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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*

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Detail: (Please describe the problem specifically)*

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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:*

Job number or JS# :*

Chair Model Name and Description:

Where is the product located?

Company Name*

Address*

Site Contact Name*

Site Contact Mobile Number*