Glassware Repair Form

Billing Company Name

Billing Address

Billing City

Billing State

Billing Zip Code

Shipping Address Same as Billing Address

Shipping Company Name

Shipping Address

Shipping City

Shipping State

Shipping Zip Code

Contact Email

Contact Phone Number

Special Instructions (Check all that apply) Special Instructions (Check all that apply) Return non-repairable items Call with quote prior to repair Rush (nominal fees apply)

Other Special Instructions

I will/have ensured that all items have been cleaned of all substances that may pose a health hazard

DIGITAL SIGNATURE (ENTER FULL NAME HERE)

13 + 13 =

Ship items for repair to:

Precision Glassblowing 14775 E Hinsdale Ave Centennial, CO 80112

All repair work is accepted on a best effort basis with no guarantee or warranty of a successful repair. Your glassware may be further damaged or destroyed in the repair attempt. We do not accept liability of any kind for damage to the glass or the loss of the object. You will not be charged for any of our efforts or time if the repair attempt fails.