- Service Star Dental Work Order with Shipping Address -

       
  Make and Model of Item:    
  Serial Number of item if Applicable:    
     
  Symptoms of Failure - Be Specific:  
     
       
  Is the problem Intermittent?  (Important)  
  Return Shipping Address:    
       
   
   
  Do you want us to return ship with insurance?
If yes, what value?		    
  Your Phone Number:  
  Person to contact with Findings / Cost:    
  e-mail address for easy communications:  
       

Call (508) 589-4172 if you have any questions. 

Print form (landscape layout), fill-in, and include with your shipment.

Be sure to package in bubble wrap and ship in a suitable container via USPS, UPS, Fed-ex or carrier of your choice.  If the contents are expensive to replace, you may want to buy shipping insurance.
                                                                                                                                                                                                       
Shipping Label: