Water Cooler Service Request

 

Let us solve your water cooler problems. If you need our services, please fill out the service request form below. We will respond to your request as soon as possible. If you prefer, you can call us at (513) 381-5758.

 

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When Is Service Required? 

 

Contact Information

Name of person requesting service:

Phone: (include area code)

Extension:

Cell Phone: (include area code)

Pager: (include area code)

Email:

 

Location of Service Requested

Company or Business Name:

Street Address:

Suite, Floor, Bldg #, etc.

City:

State:

Zip:

 

Equipment Information       (Please provide any information available)

Equipment Manufacturer

Model Number (If known)

Serial Number (If known)

Location of cooler?

Sign-in Notification Required?

Yes              No

Description of Problem: (please be as specific as possible)