About you  alt =

There are a small number of fields marked with an asterisk *. These fields must be completed before submitting the form.

  1.  
    Title
  2. This address will be used to send you a copy of your report. This will be in a printer friendly format.

  3. If you choose 'Yes', the manufacturer can ask you for more details about the device and the problem.
    We will ask them not to use your details for anything else.

    If you choose 'No', the manufacturer's investigation is limited by the information you put in this report. Please provide as much detail as you can.