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First Name
Last Name
Company
Phone Number
Email
CRAIC Product name
Product Serial Number
By whom and when was the problem first identified
Describe problem in detail
What function of the instrument were you trying to use when the problem occurred?
Has the instrument been moved?
Has any new hardware or software been added to your system?
Additional comments, if any :

If there are additional problems with your system and these are not reported, CRAIC Technologies is not responsible for the repair of these unreported issues. If you have additional problems, we request you to submit each issue separately.