Issue - UltraComfort

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Is UC Tech Service currently working with the retailer on this issue?*
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Model #*
Serial #*
Issues*
- Quality
- Major Malfunction
- Concern
- Freight Damage
- Order Issues
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Order Number
Retailer's Account Number*
Retailer Name
Retailer Address
Street Address Address Line 2 City State ZIP Code
Would you like someone to reach out to the retailer regarding this issue?*
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If yes, please provide contact name and phone number below.
Retailer Contact Person
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Nature of Issue*
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