Enter the address of where the laser system is physically located.
Company Name	*
Street Address	*
City	*
	State/Province  * Postal Code  *
Country	*
Please Provide Contact Information
Contact Name
Email	*
Phone	*
Fax
Enter the Serial Number of your system. This number can be found on the tag located in the rear, lower left corner of your laser system.
Serial Number
Model
Laser Power
Please select the reason for contacting us today.
	I have a general question My system is not functioning properly
Please type in your question or describe the problem, providing as many details as possible. Consider the following:
	• How or when did the problem begin? • Did the problem start suddenly or has it developed over a period of time? • Do you recall if some event may have occurred at the same time the problem began? • Have you replaced any parts on your machine prior to this problem?
	What steps have you taken in an effort to solve the problem?
Thank you for completing this form. Please check your entries and click on the "SUBMIT" button below. This form will then transmit directly to our Technical Support Department where it will be answered by the first available technician during our regular business hours.