CUSTOMER REPAIR REQUEST FORM

URL

This field is for validation purposes and should be left unchanged.

For questions, contact WorkSite Lighting Customer Support at 877-861-5255 or [email protected].

Send Repairs back to:

Repairs
WorkSite Lighting
10601 Cherry Hill Ave.
Baton Rouge, LA 70816

CUSTOMER INFORMATION

Contact Name(Required)

First Last

Company/Location

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

ITEMS FOR REPAIR(Required)

PART #

QUANTITY

UNIT/SERIAL #

DESCRIPTION

REPAIR COMMENTS

NOTE: Click the + icon at the end of the row to add additional items (up to 10)

ADDITIONAL NOTES