Sensor Failure Claim Form

Please note that this form is for direct VIQUA customers only. For indirect customers or end users, please contact your dealer or VIQUA support.
Reference Case Number (if known)
You may have a case number from technical support. If so, enter it here.
Sensor Part Number*
Sensor Serial Number*
Purchase Date (end user)
MM slash DD slash YYYY
Failure Description*
Was the quartz sleeve cleaned?*
Was the sensor tip soaked in de-scaler for 30 minutes?*
Was a dry test completed?*
Was the sensor still in alarm during dry test?*
Controller Serial Number
Was a replacement part installed?
Did it fix the problem?
Upload Relevant Documents
Déposer les fichiers ici ou

Taille maximum des fichiers : 50 MB.
Images, videos, receipts
Requested Compensation*
VIQUA Direct Customer Information
VIQUA Direct Customer Company Name*
VIQUA Direct Customer ID
Adresse postale Ville État / Province / Région ZIP / Code postal Pays
VIQUA Direct Customer Contact Name*
VIQUA Direct Customer Email*
VIQUA Direct Customer Phone*

VIQUA Direct Customer Information