SERVICE REQUEST

To place a service or maintenance request, please complete the form below. You may also call 905.672.1255 ext. 412 or send an email to service@bluegiantsolutions.com.

NOTE: Fields marked with an asterisk (*) must be filled out.

CONTACT DETAILS

Company Name*:

Contact Person*:

Contact Phone*:

Email*:

Street Address*:

City*:

Province:

Postal Code:

Billing Address

If billing address is different from the company address, please provide details.

Street Address:

City:

Province:

Postal Code:

Job Site

Please list site address.

Job Contact*:

Phone:

Street Address*:

City*:

Province:

Postal Code:

Brand Name*:

Product*:

Type of Service*:

Model:

Serial Number:

Problem Experienced:

Picture Upload:

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