Tech Support Request Form

Customer Technical Support Request

Please complete this form with as much information as you can. We will use it to open a support call and contact you using the most appropriate method as soon as possible. The more information you can provide here the easier it is for us to assist you efficiently. If you are not currently a CHA customer you must register with us to receive technical support. Please log in to our commerce server to register. You may also call our support center at 949-251-9000. If you have related printouts or documentation you can fax them to 949-251-9130.

Administrative Information
Company Name
Your Name
Company Phone#
Company Zip Code
Site Phone# Next 2 Hours (if different)
Fax#
E-mail
Printer or scanner model#
Sub-assembly part number
Is this a warranty issue?	Yes No
If this is a warranty issue please enter the number on the small bar-coded label attached to the product.	BTA

General Problem
Dead
AC power related
DC power related
Noise (clunks, squeaks, etc.)
Communication
Image/print quality
Problem Consistency
Solid
Reproducible (works somewhat)
Intermittent
If intermittent how often?


Interface Type
Centronics
Dataproducts
Serial
Serial Config (ex: 9600, 8, N, 1)
Serial handshaking protocol	x-on/x-off hardware
Cable length (feet)
IBM Twinax
IBM Coax
USB
Wireless
Ethernet
	10/100 BaseT 10 Base 2

Network Protocol
	TCP/IP
	Netbeui
	Net bios
	Other
SCSI	Device ID (0-6)

Please provide a detailed description of the failure symptoms.

Will the unit run it's self test? Yes No

If the unit lists any error codes what are they?

Do you have a copy of the working configuration listing? Yes No

How long has the unit been installed?

Has it ever worked correctly? Yes No

Are there other identical units at the site that can be used to verify other environment variables? Yes No

What documentation do you have available? Service Manual Users

What have you done so far to try and correct the problem?

When you submit this form it will be transmitted to our technical support group. We will set up a support call record and contact you via the most appropriate means as soon as possible. Our technical support service is available from 7 to 5 pm PST. Verified warranty issues receive first priority.