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Service

First Name*

Last Name*

Email*

Phone*

Billing Address

Company Name

Department

Floor #

Room #

Original FO #*If you don't have your Original FO #, please enter your approximate Date of Purchase

Order # / Purchase Order #

Product Manufacturer*(e.g., Herman Miller)

Product Model*(e.g., Mirra 2, Aeron)

Service Type*

Service RequiredDescribe the issue that needs to be fixed (e.g., arm rest is broken)

Service AddressLocation of the Service Call and/or shipping address for replacement

Product LabelUpload an image of the product label (4MB max), which can usually be found underneath the product.

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Product ImageUpload a clear image of the area of the product that is damaged (4MB max)

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Springdale, AR

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