Service Request Form |
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| Serial # |
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Customer Information |
| Contact Name |
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| Company Name |
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| Phone Number |
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| Fax Number |
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| Billing Address |
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| Shipping Address |
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| Please list units being returned: |
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| Esitmate required before repair?
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| Reasons for Return |
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| Special Instructions |
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Shipping Method Requested for Return |
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| Collect Account# |
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Please Note |
- Once the form has been submitted, you will receive a RMA within 24-hours. Please include the RMA with your return. You will also receive shipping information on where to send your return.
- There is an $85.00 estimate charge per instrument. Estimate fee is waived if unit(s) is repaired, or a new unit(s) is purchased, as a replacement, from the service department.
- Shipping charges are additional and are generally pre-paid and added to the invoice.
- Payment must be by credit card or purchase order.
- DO NOT return compressed gas cylinders with repair.
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| For more information, call 1-800-697-4677 ext. 1086 to speak with a technical service representative. |