Scuba.com
Repair Service Request Form

To help us process your repair quickly please print this form, complete and
include it in the box with your repair.
Please note that the more detail you provide to us will result in the faster processing of your repair.

Payment Option:

__ Credit Card	Name on Card	_______________________________________________
__ Call for Payment	Credit Card#	_______________________________________________
	Expration Date (MM/YY)	_______________________________________________

Item for Repair	Serial Number	Date of Last Service

Reason for Repair:

__ Non-Warranty Service/Repair

__ Warranty Service/Repair*

__ Other

*Must provide proof of warranty. Copy of your receipt of purchased from an authorized retailer, warranty card, etc... 

Our Repair Policy

Unless the customer provides proof of warranty (Copy of your receipt of purchase from an authorized retailer,
warranty card, etc.) the cost of parts will be added to the estimate.
Note: Tanks may need internal cleaning and/or liner removal which may increase the cost of servicing substantially.
Scuba.com is not responsible for equipment not paid for within 90 days
and all such equipment will be sold to recover repair costs.

Signature:_______________________________    Date:______________