Fill Our Repair Form | Chim-Scan®

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Repair Form

Repair Form
Printable version

Click here to see how long it will take via
UPS , FEDEX , USPS

Language

English (US)

Chim-Scan Repair Form
Name *

First Name Last Name
Company Name *
Company Owners Name *

First Name Last Name
E-mail *
We don't sell or share info.
Phone Number *
please list office phone or cell phone
Date

Month Day Year
Chim-Scan® Serial #
This will be located under the handle of the unit and in your manual.
Why do we want to know all of this:

Because it can take up to 4 business days(depending on your location and how you send it) for your unit to arrive here. This form acts as a packing list for us, so should the box be damaged, we can verify we have everything you sent. Also, this form helps us know who sent the unit and where we need to send it back to, shipping tags don't always give us the information we need.
Preferred Shipping Method *

UPS USPS - Mail
SHPIPING Address: *

Street Address

Street Address Line 2

City State

Zip Code
Billing Address

Street Address

Street Address Line 2

City State

Zip Code
Has the company changed location in the last 2yrs?

Yes No I don't know Yes and I listed the new address
**If you want us to ship the repair back with UPS - we ship Ground unless you request faster shipping. NOTE: 3rd, 2nd, and Next day shipping is expensive.

Ground is fine 3 day - only useful if you live in NJ, DE, CT, VT, NH,ME,AZ,NV,OR,CA,WA,ID 2nd Day 2nd Day - Early AM - 10am - Usually double Next Day - is always over $100 Next Day - early AM - 10am - always over $110
Tell us what's going on, what happened, what it's not doing, or what it's doing which it's not suppose to do *
Send us a Photo of the broken part.
Upgrades / Updates

No, Just fix it Not right now, but send info on what can be done Yes, put in Lighthouse switches Yes, put in the SD bypass Yes, put in the combo switch(s) Yes, put in the Lighthouse, Combo, and SD bypass switches I'm open to updating/upgrading the unit, but want info before I decide
How does this help you??

By filling this out, you not only help us but you help your office staff (even if you are the office staff) what needs to go, what your sending, when you sent it and why your sending it. If you keep a copy of this you can track how often your sending a unit or units back for repair and what needed repaired. This way if you notice your always sending a cable back for repair you can track down the cause.
What are you sending??

Whole Unit - Controller, Camera, Cable, and Case Just the Controller Just the Camera Just the Cable Controller and a Camera Camera and Cable Multiple Cameras - please wrap each camera separately Mutiple Cables Multiple Whole Units - Please Ship in separate boxes, damage is more likely if units are packed together. No Clue / Not Really Sure
What type of Image/Video recorder does the unit have

None SD Recorder CF or Compact Flash Mavicap / Floppy Disk VCR DVD Polaroid Camera - was new in 1980 Combo of 2 or more listed
What type of Camera

Auto Focus Auto Focus Tilt / AFT Enviro Camera / ENV Enviro in a Cheesehead or Cheesebit bracket Cheesehead Auto Focus Camera / CAF Combo Camera / LHC Round Camera Cube Shaped Camera Recrtangle Shaped Camera
Please verify that you are human *
Should be Empty:

1643 Old Hwy 34 Fairfield, IA 52556
Office phone# 641-472-7643
Email: Info@chimscan.net

Copyright © 1984 to 2021 Estoban Corporation. All rights reserved.

Home
Products
Repair Form
How to Order/Order Page
Homeowners page
Testimonials
About
Videos
Contact
ScanMan's Blog
Chimney Sweep Lore
FAQ
TroubleShooting Guide
LINKS
Current Customers
- Camera upgrades