Service Request Form

Pool Company information

Are you a pool company requesting service for a customer?

Pool Company Name

Contact Person

Phone

When the job is complete, how should we notify you?

Phone

Fax

Customer Information

Title

First Name

Last Name

Phone

Would you like to subscribe for our monthly email newsletter?

Address

Address 2

City

Zip Code

State

Country United States of America

Service Request

Brand of Equipment requiring service

Please Specify

Date of Installation

Model Number

Serial Number

Please describe problem with equipment

Standard 1-year warranties are extended to 3-years if you have 3 or more Sta-Rite and/or Pentair items. If you do, please specify below

Item #1

Model Number

Serial Number

Install Date

Item #2

Model Number

Serial Number

Install Date

Item #3

Model Number

Serial Number

Install Date