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
Symptom*
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 Part Number Used with Sensor
Alarm on Controller*
Controller Serial Number
Was a replacement part installed?
Did it fix the problem?
Replacement Part Number
Replacement Part Serial Number
Upload Relevant Documents
Max. file size: 50 MB.
Images, videos, receipts
Requested Compensation*
VIQUA Direct Customer Information
VIQUA Direct Customer Company Name*
VIQUA Direct Customer ID
Street Address City State / Province / Region ZIP / Postal Code Country
VIQUA Direct Customer Contact Name*
VIQUA Direct Customer Email*
VIQUA Direct Customer Phone*

VIQUA Direct Customer Information