Service Request

Are you experiencing a concern with your KuriCrimp Crimper or other KuriCrimp Hose and Tubing Processing Equipment? Please complete the following fields to be contacted by a KuriCrimp Representative.

CONTACT INFORMATION

Fields marked with * are required.

Name*

Company*

Email*

Phone*

City*

State*

PREFERRED CONTACT METHOD

Email Phone

PRODUCT INFORMATION

Machine Type*

Serial Number*

Kuriyama Part Number*

Date Equipment Received*

Date Equipment Commissioned*

SERVICE REQUEST INFORMATION

Photo or Video File size limit is 10MB

What Happened?*

Priority*

Low (Not Currently Impacting Orders)
Medium (Needed for Pending Orders)
High (Needed for Current Orders)