Product repair request

User information

Your name
Company or University
Department
Title
Zip Code or Postal Code
Country
Address
Phone number
Fax number
Email address
Verify email address
Other
Repair report Addressee

Limited to customers that have a transaction account with Ushio.

※ご発送品詳細

Product name

Free text input.
* Use “+” to add additional items.

If the product being repaired is shipped in multiple packages, please so indicate.

Serial No.

Free text input.
* Use “+” to add additional items.

Remarks

If the product being repaired is shipped in multiple packages, please so indicate.

Enter description of trouble

The description can be entered on the customer’s own form.

Your request to Ushio

* Your cooperation will help ensure smooth handling.
□ Following evaluation, a repair estimate will be be submitted to the contact person indicated on the estimate request form.
□ If the place to which the repaired product is to be returned differs from the contact address, please indicate the shipping information (address, contact information, and name of person responsible) in the “Your request to Ushio” space.
* Contact for receiving confirmation and delivery time inquiries: Customer Service Center, CS Section  TEL: 045-901-2642