Malibu Scuba Repair Service Intake
First Name
Last Name
Phone Number
Email
Text me about my gear (optional).
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Select Items for Service:
Regulator
BCD
Tank
Dry Suit
Dive Computer
CCR
Other (Misc. Gear)
+ Add Additional Regulator
+ Add Additional BCD
+ Add Additional Tank
+ Add Additional Dry Suit
+ Add Additional Dive Computer
+ Add Additional CCR
+ Add Additional Item
Additional Comments
Submit Service Request
Regulator System
Remove
Select Components:
1st Stage
2nd Stage
Octo
Safe 2nd
SPG
Digital SPG (Non Computer)
Transmitter
1st Stage
Manufacturer *
Model *
Select Manufacturer First...
Serial Number
2nd Stage
Manufacturer *
Model *
Select Manufacturer First...
Serial Number
Octo
Manufacturer *
Model *
Select Manufacturer First...
Serial Number
Safe 2nd
Manufacturer *
Model *
Select Manufacturer First...
Serial Number
SPG
Brand *
Digital SPG (Non Computer)
Brand *
Transmitter
Brand
Model
Serial Number
Services Requested (applies to the whole regulator system):
Complete Annual Service With Electronic Flow Telemetry
Service SPG
Environmental Seal
Replace Transmitter Battery
Service Digital SPG
Replace Digital SPG battery
Replace Primary LP Hose
Replace Secondary LP Hose
Replace LP Inflator Hose
Replace HP Hose
Bench Check Only
Service Oceanic Quick Disconnect Hose
Expedited Service
BCD
Remove
Brand
Model
Serial Number
Services Requested:
BCD Bench Check
BCD Bench Check and Inflator Replace
BCD Bench Check and Inflator Rebuild
Other
Tank
Remove
Material
Select...
Aluminum
Steel
Carbon Fiber
Other
Capacity (cu ft)
Serial Number
Services Required:
Visual Inspection
Hydro Testing
Tumble
Tank Valve Service
Other
Dry Suit
Remove
Manufacturer
Select...
DUI
Santi
Other
Model
Serial Number
Services Required:
Replace Neck Seal
Replace Left Wrist Seal
Replace Right Wrist Seal
Bench Check & Leak Test
Fix Leak
Alterations
Dive Computer
Remove
Make
Model
Serial Number
Transmitter Included
Transmitter
Brand
Model
Serial Number
Services Requested:
Replace Battery & Pressure Test
Transmitter Battery Change
Other
CCR
Remove
Manufacturer
Model
Serial Number
Services Required:
Annual Service
Specific Problem
Miscellaneous Item
Remove
Make and Model
Serial Number (if applicable)
Description of Service Needed: