Customer is encouraged to provide detailed information, documents, and pictures using this online form to avoid any fees. Contact information must match documents on file:Name* First Name Last Name Email* Home NumberMobile Number*Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Installation Date* MM slash DD slash YYYY Purchased Date* MM slash DD slash YYYY Detailed description of the issue*Please upload 2 photos of the issue*Must upload at least two photos. Please submit clear photos with multiple angles. Not all photos should be close ups. Drop files here or Select files Accepted file types: jpg, png, Max. file size: 50 MB. Please upload copy of the contract*Accepted file types: jpg, png, pdf, jpeg, Max. file size: 50 MB.Please read and check each item below:* Customer acknowledges they are the original owner(s) of the item/product who purchased products/services through a Convertabath contract. By submitting this claim form, customer acknowledges the following:* Customer understands Convertabath may require an inspection before an issue is determined as a qualified claim. By submitting this claim form, customer acknowledges the following:* Customer understands a minimum service fee of $95 may be required if a service call reveals no workmanship or material defects within the warranty period. By submitting this claim form, customer acknowledges the following:* Customer understands no warranty request will be honored if it is determined there is no failure of product or installation. By submitting this claim form, customer acknowledges the following:* If a warranty claim has been denied, customer will have the option to hire Convertabath to repair or replace the item/product with fees to be determined through the estimate process. By submitting this claim form, customer acknowledges the following:* Customer understands if a warranty claim is submitted after the warranty period has expired, the claim will be denied. Customer may request an estimate at that time. CAPTCHADate* MM slash DD slash YYYY By clicking SUBMIT, you acknowledge that all information provided is accurate and true to the best of your knowledge.EmailThis field is for validation purposes and should be left unchanged.
