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Service

First Name*

Last Name*

Email*

Phone*

Billing Address*

Company Name

Department

Floor #

Room #

Original FO #* If you don't have your Original FO #, please enter your approximate Date of Purchase

Order # / Purchase Order #

Product Manufacturer* (e.g., Herman Miller)

Product Model* (e.g., Mirra 2, Aeron)

Service Type*

Service Required* Describe the issue that needs to be fixed (e.g., arm rest is broken)

Service Address Location of the Service Call and/or shipping address for replacement

Product Label Upload an image of the product label (4MB max), which can usually be found underneath the product.

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Product Image(s) Upload one or more clear photos of the area of the product that is damaged (up to 5, 10MB total max)

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