Office Phone 24 Hours: (908) 534-8577
Fax (908) 534-8851


456 US Hwy 22 West, Suite 7 

Whitehouse Station, NJ 08889

Service Request Form

Please use the form below to Request an In-House/Pick Up Service of your unit that is in need of repair.

Contact Info
Name: (First + Last)
Street Address:
City:    State:      Zip:
Home Phone: Cell:   
Best Form of Contact:
E-Mail   ||     Cell Phone ||     Home Phone
Unit Information:
Make:   Model:
Serial Number: (If Available)
Purchase Date:  
Under Warranty?  Yes  ||   No || Don't Know
Location of Television:
(i.e. 2nd floor, 3rd floor, Basement, Etc...)
Problem with the Unit:
Any Other Comments: