JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
SOMEL SERVICE
CHAMADO TÉCNICO
Sign in to Google
to save your progress.
Learn more
* Indicates required question
www.gruposomel.com
FABRICANTE DO EQUIPAMENTO
ITEAD
FUJI
CARESTREAM
Other:
Clear selection
MODELO DO EQUIPAMENTO
*
Your answer
TIPO DE SERVIÇO
*
CONSERTO
MANUTENÇÃO PREVENTIVA
APLICAÇÃO
TREINAMENTO
Other:
Required
DESCRIÇÃO DO PROBLEMA
*
Your answer
PESSOA PARA CONTATO
*
Your answer
TELEFONE
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This form was created inside of Grupo Somel.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report