Scheduling a Visit Intake Form

Please fill out this form with as much detail as possible to help us schedule your request efficiently.
Prefer email? Send the required information to LSCScheduling@Lutron.com instead.

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* 1. Requestor Name

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* 2. Requestor Phone Number

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* 3. Requestor Email Address

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* 4. Site Name / Name of Business

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* 5. Site Address

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* 6. Site Contact

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* 7. Site Contact Phone Number

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* 8. Site Contact Email Address

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* 9. System Type

Athena

Vive

Quantum

myRoom XC

LCP / XPS

QS Standalone

I don't know

Other System Type (please specify)

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* 10. Service Type

Startup

Service / Warranty

Training

Other Service Type (please specify)

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* 11. Job Number, if known (ex: 2150309, 145738)

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* 12. When would you like service to take place/begin?

Requested Date

Date

Scheduling a Visit Intake Form

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* 1. Requestor Name

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* 2. Requestor Phone Number

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* 3. Requestor Email Address

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* 4. Site Name / Name of Business

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* 5. Site Address

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* 6. Site Contact

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* 7. Site Contact Phone Number

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* 8. Site Contact Email Address

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* 9. System Type

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* 10. Service Type

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* 11. Job Number, if known (ex: 2150309, 145738)

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* 12. When would you like service to take place/begin?

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* 13. Reason for Visit