Customer Service Contact


Date:                          Time:                         DNTL Rep:                                              

Customer:                                                                                                                  

Contact Person:                                              Telephone:                                              

Purpose of Call:Problem Resolution:                                 Complaint*:                          
               Other (specify):                                                                                                                                                                               
               
Details of Problem/Complaint:                                                                                       
                                                                                                                                
                                                                                                                                
                                                                                                                                
                                                                                                                                

Corrective Action Taken (include time frame):                                                                                 
                                                                                                                                
                                                                                                                                
                                                                                                                                
                                                                                                                                

Other Comments (shipping priority, address, etc.):                                                                                   
                                                                                                                                
                                                                                                                                
                                                                                                                                
                                                                                                                                

Follow-up Required? þ No       þ Yes     Date:                              
Date Reconciled:                         þ Warranty      þ Non-Warranty
*Product Name:                                                                                                           
Part Name:                               Part #:                                               
þ Product Replaced  þ Product Serviced   þ Response not required
þ Part Replaced     þ Part Serviced      þ Response not required
Conclusions (ie. device defective, improper use or maintenance, shipping damage, other):                                                             
                                                                                                                                
                                                                                                                                
                                                                                                                                
                                                                                                                                

     

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