Repair Form

Note: In some cases we can come out and repair the unit on site or remove and refit once repaired, this service incurs an additional callout charge. We can only offer this service if you are located within the Map as shown.

Please complete the repair form below; submit your details, then print your repair form and send it along with your unit to:

Repair Form

Name:

Email:

Landline Telephone:

Mobile Telephone:

Address Lane 1:

Address Line 2:

County:

Post Code:

Make:

Model:

Year of manufacture:

Vehicle Reg:

Mileage:

Petrol or Diesel:

Manual or Auto:

Brief Description of the Problem:

Any Additional Information:

Chosen method of payment: *
BACS TransferPayment over TelephoneCheque with parcel made payable to “Electrotech”

* Payment will not be required until repair is complete and ready for dispatch.