Hensley Cooler Request Form

Please complete all form details for submission. Please note, submitting this form does not guarantee you a cooler. We will get back to you within 48 hours of your request with information on availability and further instructions.

Name(Required)

First Last

Phone(Required)

Email(Required)

Role(Required)

Sales Rep‎

Team Lead‎

Segment Manager‎

Region(Required)

Account Name(Required)

Hensley Account Number(Required)

Request Type(Required)

New Cooler Request

Return Cooler

Requested Cooler Pick Up Date(Required)

Same day requests or pick-ups are not allowed. Please allow for three business days from the date you submit the form to pick up the cooler.

Is this a supplier cooler or Hensley Cooler?(Required)

Hensley Cooler‎

Supplier Cooler

How Many?(Required)

Which Supplier?(Required)

Total Coolers?(Required)

Cooler Type (Dimensions LxDxH)(Required)

Describe Cooler Type(Required)

Cooler Serial #(Required)

Serial information is required in order to track inventory. Multiple serial #'s space with comma

Additional Notes?

Confirm the following troubleshooting areas

Is the cooler Plugged In?‎

Check the breaker/Outlet tripped?‎

Was anything blocking the fans/removed?‎

Radiator(Bottom) Cleaned?‎

Maintaining a temp?‎

Brands Going into the Cooler(Required)

Electronic signature(Required)

HOW CAN WE SERVE YOU?

We’d love to hear from you.

Send us a message and we’ll respond as soon as possible.

Hensley Cooler Request Form

HOW CAN WE SERVE YOU?

We’d love to hear from you.

OFFICE HOURS: