Request for Parts and/ or Service

Thank you for contacting WSR Solutions! We look forward to working with you. To assist you in the most efficient and timely manner, please fill out the following form. Please note:

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Providing an email address will allow us to get you back the information you need the quickest.
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Once the form has been submitted you will receive a pop up with a repair ID number - this number will be your case file number.
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You will receive an email and/or a follow-up text from a Customer Service Representative within 24 business hours of submission, and/or a phone call in approximately 48–72 business hours after submission.
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If you have any questions or issues with submitting the online form please see our chat option on our website. During business hours there is a live chat representative that can assist. After business hours you can leave a message on the online chat and a representative will answer you promptly the next business day we are open for regular business.
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We would be happy to locate a technician of ours in your area. Our services are completed at your home and the tech service call fee begins at $185.
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If you would like a quote on parts or would like us to verify warranty status (We can only verify warranty status on certain manufacturers and/or purchased equipment from certain dealers) a serial number is REQUIRED. WSR Solutions is a third-party nationwide repair company that works with many manufacturers, dealers (both online and local), and VA Centers. We are not the manufacturer, nor are we the dealer that sold you your equipment. We do submit your information to the manufacturer to verify warranty status on parts and/or labor on your behalf.

Owner Information

First Name *
Last Name *
Email * (Please provide email - this is the
best form of contact for quicker response)
Address *
City *
State *
Zip *
Cell Phone *
Alternate Phone *

Medicare Information

If you would like to check eligibility for repairs through Medicare the below information is required (power chairs and scooters only). Without the information below we cannot run eligibility for repairs through the Medicare system.*** If not applicable please use N/A in both spots below
Medicare Number
Date of Birth

Equipment Information
Manufacturer/ If unknown or can’t locate please put UNKNOWN) *
Make and Model/ If unknown or can’t locate please put UNKNOWN) *
Serial Number (required if requesting a parts quote, or a check on warranty)
When was your equipment purchased/ received (month and year)?
Where was your equipment purchased from (if unknown please put UNKNOWN)?* ?

Service and/or Parts needed
(IE: evaluation, warranty check on parts and/or labor, parts quote request, etc):

We would be happy to locate a technician of ours in your area. Our services are completed at your home and the tech service call fee begins at $185.

Please tell us which of the following applies: Would you like an evaluation, do you want a quote on a part, have parts that need to be installed with you now, or want a quote on a part AND a tech to install?*

If you have parts on site for repair, please list what you have on site that needs to be installed. If you have a unit that needs to be set up (ie: hospital bed, power chair, etc), please provide what type of product it is that needs to be set up and if there are any stairs in the home and where the product is currently located.(If not applicable please use N/A):*

Do you need a quote on parts? (If you would like a quote on parts serial number is required) List parts here (If not applicable please use N/A):*

Please tell us a little about what your concerns/ issues are with your equipment equipment (IF requesting a warranty verification on parts and/or unit- please provide what happened, or what is wrong. The Manufacturer does require a description of what the possible manufacturer defect is to provide warranty cost or coverage):*


SUBMIT