Instrument Service & Repair Form

Please fill out the form regarding your instrument. A certified technician will reach out to you at Carolyn Nussbaum Music Company in 1-3 business days to proceed with next steps upon form submission.

Contact Information

Email *

First Name *

Last Name *

Billing Address *

City *

State *

Zip Code *

Phone Number *

Return shipping information same as above?

First Name *

Last Name *

Return Address *

City *

State *

Zip Code *

Instrument Work Request

Work Required *

Clean, Oil, & Adjust (COA, Annual Maintenance)
Overhaul Pads: Felt
Overhaul Pads: Straubinger
Repair (describe below)
Upgrade / Enhancement (describe below)
Don't know (please evaluate)

If this was for a COA or Overhaul, did you have an appointment with us?

Pre-Scheduled Appointment Date

Special instructions or additional work requested (include any schedule considerations)

Instrument #1 *

Make / Manufacturer *

Model *

Serial # *

Upload Photos & Videos

Supplying our technicians with photos and videos with your instrument with help accelerate the process of evaluation.

How many instruments are you submitting? *

Instrument #2 Details

Instrument #2 *

Instrument #2 Make / Manufacturer *

Instrument #2 Model *

Instrument #2 Serial # *

Instrument #2 Photos & Videos

Supplying our technicians with photos and videos with your instrument with help accelerate the process of evaluation.

Instrument #3 Details

Instrument #3 *

Instrument #3 Make / Manufacturer *

Instrument #3 Model *

Instrument #3 Serial # *

Instrument #3 Photos & Videos

Supplying our technicians with photos and videos with your instrument with help accelerate the process of evaluation.

Instrument #4 Details

Instrument #4 *

Instrument #4 Make / Manufacturer *

Instrument #4 Model *

Instrument #4 Serial # *

Instrument #4 Photos & Videos

Supplying our technicians with photos and videos with your instrument with help accelerate the process of evaluation.

Instrument #5 Details

Instrument #5 *

Instrument #5 Make / Manufacturer *

Instrument #5 Model *

Instrument #5 Serial # *

Instrument #5 Photos & Videos

Supplying our technicians with photos and videos with your instrument with help accelerate the process of evaluation.

Terms of Service

Note: Please DO NOT ship us your instrument until we have contacted you on your service request.

1.) Evaluation - Once we have received your instrument and evaluated it we will contact you via phone or email to discuss cost and schedule estimates and obtain approval for the work recommended.

2.) Payment - you will be contacted via phone or email for payment once the work is completed unless provided during initial approval.

3.) Schedule - items not claimed after 30 calendar days following notification of work completion become property of Carolyn Nussbaum Music Company and may be sold.

4.) Shipping - ship all items to the address shown above. Ship items in a sturdy box with a minimum of 3 inch of padding all the way around in accordance with your shipping carrier instructions. Instruments should be shipped in their hard case and soft case cover (if available).

If you have any questions please call us at 972-985-2662 or email us at info@flute4u.com

Authorization of Work

I authorize Carolyn Nussbaum Music Company to perform the requested work (labor and materials) on my instrument(s).

I agree to the terms of service above and authorize work upon initial evaluation & agreement of instrument scope-of-work.

Date of Authorization

Thank you for getting in touch with us!

One of our technicians will get back in touch with you in the next 1-3 business days.

We thank you for your business and look forward to taking care of your instrument!

Thank you for getting in touch with us!

One of our technicians will get back in touch with you in the next 1-3 business days.

We thank you for your business and look forward to taking care of your instrument!

Patriotic Music