XeMODeX New Product Request Form

Custom Request Form

Can’t find the part you are looking for on our website? Don’t worry, we should still be able to offer you a custom testing and repair service.

We have completed hundreds of successful repairs on parts that are not listed on our website. These parts are not listed because the testing process is not 100 percent completed or because not all the failure symptoms can be addressed by us. Please complete this repair request form and we will get back to you as soon as we can.

Keep in mind that if your part is not repairable, in most cases we can transfer the software, coding, VIN number and mileage to a matching good used unit. You will end up receiving a good working unit that is ready to be installed without any need for further programming. Plug and Play installation.

Please visit our How to Place an Order page for a detailed overview and frequently asked questions about our custom order process.

Company name
Contact name*
Address
Street Address Address Line 2 City Province Postal Code
Phone number*
Email*
How did you hear about us?*
Please Specify
How often do you come across this type of failure?*
Have you ever used any of our services in the past?*
Vehicle’s make*
Model*
Year*
VIN (Vehicle Identification Number )*
Part name*
Part number
Diagnostic trouble codes
Failure description*
File
Accepted file types: jpeg, jpg, gif, png, pdf.
Accepted file types: jpeg, jpg, gif, png, pdf Maximum File Size 2MB

Please Note: Infected files will be automatically deleted without a record of them been uploaded. Please make sure your computer is free of suspicious viruses prior to upload. Thank you
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XeMODeX New Product Request Form

Custom Request Form