Pirates Cove Scuba
Repair Service Request Form

www.piratescovescuba.com

 

To help us process your repair quickly please print this form, complete and
include it with your equipment.
Please note that the more detail you provide to us will result in the faster processing of your repair.

First Name: _______________________________________

Last Name: ________________________________________

Address: ____________________________________________________________________________

 

City: ________________________________________________

State: __________________

Zip: _________________

Phone: ______________________________________________

Email: ____________________________________

Payment Option:

__ Credit Card

Name on Card

_______________________________________________

__ Call for Payment

Credit Card#

_______________________________________________

 

Expration Date (MM/YY)

_______________________________________________

 

Item for Repair

Serial Number

Date of Last Service

 

 

 

 

 

 

 

 

 


Reason for Repair:

__ Non-Warranty Service/Repair

__ Warranty Service/Repair*

__ Other

*Must provide proof of warranty. Copy of your receipt of purchased from an authorized retailer, warranty card, etc... 

Explanation: (required for repair)
Please note that the more detail you provide to us will result in the faster processing of your repair.
say: "Broken zipper halfway under left arm"       instead of: "Broken zipper"

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

Our Repair Policy

Unless the customer provides proof of warranty (Copy of your receipt of purchase from an authorized retailer,
warranty card, etc.) the cost of parts will be added to the estimate.
Note: Tanks may need internal cleaning and/or liner removal which may increase the cost of servicing substantially.
Pirates Cove Scuba is not responsible for equipment not paid for within 90 days
and all such equipment will be sold to recover repair costs.


Signature:_______________________________    Date:______________

 

Questions?
  Phone:   405-722-4465
  Email:   manager@piratescovescuba.com

 Pirates Cove Scuba Service Department
 
6205 N. Meridian
 Oklahoma
City 73112