Customer Support Form

Fields denoted with an asterisk (*) are mandatory.

Required Information

Name:*
Email:*
Company:*
Address:*
City:*
State/Province:*
Country:*
Zip/Postal Code:
Phone Number:
Your Position [Ex. Sales, Engineering, Etc]:
Market/Industry:*
EmbeddedCommercial/IndustrialDefenseAutonomous VehiclesRoboticsEducationHealthcareVisionOther

Product Information

Product Number(s) [Ex:CCG008, BBG001]:*
Serial Number(s):*
Operating System [Ex. Windows 10, L4T 32.2.1]:*
If Linux: Distribution, Kernel:
Problem Description:*

Additional Information (If Available)

External peripherals used:
Bit Rate (If applicable):
Module: [Ex: Congatec TS-175, Jetson TX2]:
Power Supply used (Voltage, part number, Rating):
Environmental Conditions (temperature range, lab or in field, etc):