Equipment Repair Request | American Printing House

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Equipment Repair Request

Please complete this form for equipment repair requests. A customer experience representative will reach out within 1 business day to troubleshoot your issue and initiate the repair process as required.

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This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Who owns or is responsible for any potential repair costs for the device?(Required)

Personal device

School: PO or credit card payment (Non-FQ)

Organization: PO or credit card payment (Non-FQ)

School: Federal Quota eligible

Are you an Ex Officio Trustee (EOT)?(Required)

Yes

No

EOT name (if known)

Will you be using FQ funds to pay for the repair (if allowed)?(Required)

Yes

No

Equipment information

Product serial number(Required)

Invoice number (if known)

Date of purchase (if known)

MM slash DD slash YYYY

Equipment/Model needing repair:(Required)

Monarch 1-00420-XX

Chameleon 1-09471-X

Jupiter 1-00370-X

Juno 1-00380-X

Mantis 1-08470-X

Matt Connect 1-03941-X

MATT Connect V2.1 Tablet/Stand 1-03943- X / 1-039434-X

Light Touch Brailler 1-00815-X

Next Gen Brailler 1-00800-X

Perkins Electric Brailler

Perkins Standard Brailler 1-00850-X

Smart Brailler 1-00820-X

PageBlaster 1-08075-X

PixBlaster 1-08070-X

Code Jumper 1-02700-X

Large Light Box 1-00499-X

LED Large Light Box 1-08655-X

LED Mini-Lite Box 1-08654-X

Mini-Lite box 1-00499-X

Power Select 1-00499-X

Video Mag 1-03914-X

Polly 1-08490-X

What is the general issue in need of repair (multiple selections available)(Required)

Carriage issue

Dots issue

Keys not working

Cleaning

Paper jamming/loading issue

Power/charging issue

Screen issues

Connection issues (e.g wifi, monitor, external device)

Camera issues

Other

Please describe the issue with the equipment. Please be as specific as possible.(Required)

I acknowledge, when not covered by APH or vendor, APH recommends shipping via UPS or USPS with tracking and insurance to confirm delivery and protect my property. Units shipped USPS Free Matter for the Blind do not have tracking available and may take up to 30 days to arrive with no insurance coverage if lost. If I choose to send via Free Matter for the Blind, then I understand APH is not responsible for replacement of devices that are lost in shipping.(Required)

I agree.

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