www.alhambrawater.com
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34.231.184.58
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Submitted URL: https://www.alhambrawater.com/support.jsf
Effective URL: https://www.alhambrawater.com/support/contact-us
Submission: On December 30 via api from CH — Scanned from DE
Effective URL: https://www.alhambrawater.com/support/contact-us
Submission: On December 30 via api from CH — Scanned from DE
Form analysis
2 forms found in the DOM<form>
<div class="MuiGrid-root MuiGrid-container MuiGrid-spacing-xs-4">
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-12 MuiGrid-grid-md-6">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="MuiFormLabel-root jss71 jss66" label="First Name:" for="firstName"><span aria-hidden="true">*</span>First Name:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"><input aria-invalid="false" autocomplete="given-name" id="firstName" name="firstName" type="text" aria-label="*First Name:" aria-required="true"
class="MuiInputBase-input MuiOutlinedInput-input jss58" value="">
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-12 MuiGrid-grid-md-6">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="MuiFormLabel-root jss71 jss66" label="Last Name:" for="lastName"><span aria-hidden="true">*</span>Last Name:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"><input aria-invalid="false" autocomplete="family-name" id="lastName" name="lastName" type="text" aria-label="*Last Name:" aria-required="true"
class="MuiInputBase-input MuiOutlinedInput-input jss58" value="">
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-8 MuiGrid-grid-md-4">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="MuiFormLabel-root jss71 jss66" label="Phone:" for="phoneNumber">Phone:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"><input aria-invalid="false" id="phoneNumber" name="phoneNumber" type="text" maxlength="10" class="MuiInputBase-input MuiOutlinedInput-input jss58" value="">
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-4 MuiGrid-grid-md-2">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="MuiFormLabel-root jss71 jss66" label="Ext:" for="phoneNumberExt">Ext:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"><input aria-invalid="false" autocomplete="tel-extension" id="phoneNumberExt" name="phoneNumberExt" type="text" aria-label="Ext:" aria-required="false"
class="MuiInputBase-input MuiOutlinedInput-input jss58" value="">
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-12 MuiGrid-grid-md-6">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="MuiFormLabel-root jss71 jss66" label="Email Address:" for="emailAddress"><span aria-hidden="true">*</span>Email Address:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"><input aria-invalid="false" autocomplete="email" id="emailAddress" name="emailAddress" type="text" aria-label="*Email Address:" aria-required="true"
class="MuiInputBase-input MuiOutlinedInput-input jss58" value="">
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-12 MuiGrid-grid-md-6">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="MuiFormLabel-root jss71 jss66" label="Company:" for="companyName">Company:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"><input aria-invalid="false" autocomplete="organization" id="companyName" name="companyName" type="text" aria-label="Company:" aria-required="false"
class="MuiInputBase-input MuiOutlinedInput-input jss58" value="">
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-md-6"></div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-12 MuiGrid-grid-md-6">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="MuiFormLabel-root jss71 jss66" label="Street Address:" for="address">Street Address:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"><input aria-invalid="false" autocomplete="address-line1" id="address" name="address" type="text" aria-label="Street Address:" aria-required="false"
class="MuiInputBase-input MuiOutlinedInput-input jss58" value="">
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-12 MuiGrid-grid-md-6">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="MuiFormLabel-root jss71 jss66" label="City:" for="city">City:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"><input aria-invalid="false" autocomplete="address-level2" id="city" name="city" type="text" aria-label="City:" aria-required="false"
class="MuiInputBase-input MuiOutlinedInput-input jss58" value="">
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-8 MuiGrid-grid-md-6">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="jss66 jss69" id="province-label" for="province">Province:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"
items="[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]">
<div class="MuiSelect-root MuiSelect-select jss78 MuiSelect-selectMenu jss84 MuiInputBase-input MuiOutlinedInput-input jss58" tabindex="0" role="button" aria-haspopup="listbox" aria-labelledby="province-label mui-component-select-province"
id="mui-component-select-province">Select Province</div><input name="province" aria-hidden="true" tabindex="-1" class="MuiSelect-nativeInput" id="province" value="">
<div class="MuiSelect-icon jss83 PrimaryArrow__PrimaryArrowWrapper-sc-1cqgpe2-0 gCklwT">
<div class="CaretDown-qw09zv-0 hAXAgt"></div>
</div>
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-4 MuiGrid-grid-md-3">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="MuiFormLabel-root jss71 jss66" label="Postal Code:" for="postalCode"><span aria-hidden="true">*</span>Postal Code:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"><input aria-invalid="false" autocomplete="postal-code" id="postalCode" name="postalCode" type="text" aria-label="*Postal Code:" aria-required="true"
class="MuiInputBase-input MuiOutlinedInput-input jss58" value="">
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-12 MuiGrid-grid-md-6">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="MuiFormLabel-root jss71 jss66" label="Account Number:" for="accountNumber">Account Number:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl"><input aria-invalid="false" id="accountNumber" name="accountNumber" type="text" aria-label="Account Number:" aria-required="false"
class="MuiInputBase-input MuiOutlinedInput-input jss58" value="">
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-12 MuiGrid-grid-md-6">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 88px;"><label class="jss66 jss69" id="subject-label" for="subject">*What do you need help with?</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl" items="[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]">
<div class="MuiSelect-root MuiSelect-select jss78 MuiSelect-selectMenu jss84 MuiInputBase-input MuiOutlinedInput-input jss58" tabindex="0" role="button" aria-haspopup="listbox" aria-labelledby="subject-label mui-component-select-subject"
id="mui-component-select-subject"><span></span></div><input name="subject" aria-hidden="true" tabindex="-1" class="MuiSelect-nativeInput" id="subject" value="">
<div class="MuiSelect-icon jss83 PrimaryArrow__PrimaryArrowWrapper-sc-1cqgpe2-0 gCklwT">
<div class="CaretDown-qw09zv-0 hAXAgt"></div>
</div>
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-12 MuiGrid-grid-md-12">
<div class="MuiFormControl-root MuiFormControl-fullWidth" style="min-height: 165px;"><label class="MuiFormLabel-root jss71 jss66" label="Questions/Comments:" for="comments">Questions/Comments:</label>
<div class="MuiInputBase-root MuiOutlinedInput-root jss57 MuiInputBase-formControl MuiInputBase-multiline MuiOutlinedInput-multiline jss63"><textarea aria-invalid="false" id="comments" name="comments" rows="8" aria-label="Questions/Comments:"
aria-required="false" class="MuiInputBase-input MuiOutlinedInput-input jss58 MuiInputBase-inputMultiline MuiOutlinedInput-inputMultiline"></textarea>
<fieldset aria-hidden="true" class="jss74 MuiOutlinedInput-notchedOutline jss59" style="padding-left: 8px;">
<legend class="jss75" style="width: 0.01px;"><span></span></legend>
</fieldset>
</div>
</div>
</div>
<div class="MuiGrid-root MuiGrid-item MuiGrid-grid-sm-12 MuiGrid-grid-md-12">
<div class="water-regional_button__2AQb_ styles_submit__MwqPP"><button class="MuiButtonBase-root MuiButton-root MuiButton-text" tabindex="0" type="submit" data-tracking="Submit"><span class="MuiButton-label">Submit</span></button></div>
</div>
</div>
</form>
POST https://cl.s4.exct.net/DEManager.aspx
<form action="https://cl.s4.exct.net/DEManager.aspx" method="POST"><input name="firstname" readonly="" hidden="" value=""><input name="lastname" readonly="" hidden="" value=""><input name="phone" readonly="" hidden="" value=""><input name="phone_ext"
readonly="" hidden="" value=""><input name="EmailAddress" readonly="" hidden="" value=""><input name="SubscriberKey" readonly="" hidden="" value=""><input name="companyname" readonly="" hidden="" value=""><input name="address" readonly=""
hidden="" value=""><input name="city" readonly="" hidden="" value=""><input name="province" readonly="" hidden="" value=""><input name="postalcode" readonly="" hidden="" value=""><input name="account_number" readonly="" hidden="" value=""><input
name="comments" readonly="" hidden="" value=""><input name="contact_regarding" readonly="" hidden="" value=""><input name="emailMe" readonly="" hidden="" value="yes"><input name="lead_type" readonly="" hidden="" value="contactForm"><input
name="lead_source" readonly="" hidden="" value="www.alhambrawater.com"><input name="mobile_form" readonly="" hidden="" value="yes"><input name="_action" readonly="" hidden="" value="add"><input name="_returnXML" readonly="" hidden=""
value="0"><input name="_successURL" readonly="" hidden="" value="https://www.alhambrawater.com/support/contact-us/success"><input name="_errorURL" readonly="" hidden="" value="https://www.alhambrawater.com/support/contact-us"><input
name="_deExternalKey" readonly="" hidden="" value="28AA42A0-9927-48BF-B79A-E919F35CBC77"><input name="_clientID" readonly="" hidden="" value="1057339"></form>
Text Content
Skip To Main Content Residential Business Deliver to 94124 Change▾ * Our Services Our Products * Our Story * Start Order Contact usDispensers and Accessories Manuals EXISTING CUSTOMER SERVICE {EXISTINGCUSTOMERSERVICE} GET SET UP FOR DELIVERY {CALLTOORDER} -------------------------------------------------------------------------------- > Please note: This form cannot be used to cancel service. * CALL US We’re always here to help. Our hours are 8:00 am-9:00 pm EST Mon-Fri, and we’re closed on Saturday & Sunday. * EXISTING CUSTOMER SERVICE 800-728-5508 * GET SET UP FOR DELIVERY 800-201-6218 * WRITE US We love getting mail. Primo® 200 Eagles Landing Boulevard Lakeland, Florida 33810 Frequently Asked Questions -------------------------------------------------------------------------------- * CONTACT US Have specific questions, concerns, or comments? > Please note:This form cannot be used to cancel service. *First Name: *Last Name: Phone: Ext: *Email Address: Company: Street Address: City: Province: Select Province *Postal Code: Account Number: *What do you need help with? Questions/Comments: Submit By continuing to use our site and/or providing us with your personal information, you indicate your consent to our updated Privacy Policy. SHOP * Large Bottle * Case Packs * Sparkling Water * Tea and Hot Chocolate * Coffee * Rent Equipment * Buy Equipment COMPANY * Our Company * Corporate Social Responsibility * Careers NEED HELP? * Contact Us * FAQs * Cooler Cleaning Service STAY CONNECTED * * * Customer subject to CA CASH REFUND or applicable state bottle deposits on free and purchased cases.©2022 Primo Water North AmericaPrivacy Policy | Cookie Policy | Terms of Use | CA Supply Chain | CA Notice At Collection