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):