Repair Number Request (RQT Form)

Need to send your injector to our Customer Service Center for repairs? Fill out the form below, and our service department will be in touch as soon as possible to assign an RQT number and provide instructions. You can also reach us by phone at 800-523-8499.

Canadian Customers -- please note that the Zip Code field is set up for 5-digit US zip codes only. Please enter both your city and postal code in the City field, and enter zeros in the Zip Code field.

* Indicates Required Field

*First Name:

*Last Name:

Company:

*Address:

Address2:

*City:

*State/Province:

*Zipcode:

*Country:

*Phone:

Alternate Phone:

Fax:

*Email:

*Describe your service needs:

*Industry:

Horticulture
Hygiene
Livestock
Metal Processing
Printing
Vehicle Wash
Water Treatment
Other

Please note: Information provided using this form will be used to answer your service need only. Dosatron will not share or sell your personal information to any third-party vendor. Please refer to our Privacy Policy for a complete overview of how Dosatron uses personal information provided to us.