OEM Repair/Evaluation Request | Consolidated Sterilizer Systems

Customer/Billing Information

Facility Name*

Contact Name*

Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

This field is hidden when viewing the form

Facility Name*

Contact Person*

Email*

Phone*

Address*

Same as billing address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Model*

Serial Number*

Equipment to be repaired/evaluated*

Please Choose One*

Describe the problem with the equipment*

Is an authorized CSS Service Company on-site doing the repair?*

Repair/Evaluation Priority Level*

Shipping Preference*

By checking this box, I am authorizing CSS to examine and/or repair the equipment listed above, and agree to a $250 evaluation fee which includes the first hour of labor. I acknowledge that a $200 hourly charge will accrue for each subsequent hour of repairs required.