Chair-A-Medics Service Request Form
Questions? Please email us at scheduling@chairamedics.com or give us a call at (919) 228-4478.
What is your facility name? *
Your answer
What is your facility location? *
Your answer
Who should we contact about this repair? *
Your answer
What is the contact person's email address? *
Your answer
What is the priority of your request?
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