Customer Request

Please use the following form to submit requests for the Customer Care and Billing teams.

Technical Support requests should be entered at www.fusionconnect.com/support/support-ticket/.

Contact Information

First Name *

Last Name *

Email *

Phone *

Location Information

Street Address

State *

Access Hours *

Business hours or time frame this site is accessible for a repair dispatch.

Account Information

Account Name *

Identify My Account By:

Account Number *

Request Information

Request Type? *

Request Description *

Additional Contact to CC

CC Email Address