Support

RMA Form

Please fill out the form below to request a Return Merchandise Authorization (RMA) number. You will be notified via email within 2 business days of your RMA acceptance and RMA Number. All fields must be filled out properly for RMA consideration.

Billing/Ownership Information:
Email Address:
Name:
Title:
Medical / Surgical Specialty:
Facility Name:
Facility Address:
 
City:
State:
Zip Code:
Country:
Phone Number:

Pump Information:
Model Name/Number:
Serial Number:
Loaner Pump Requested?  Yes    No
Patient Injury?  Yes    No

Reason for RMA Request: (Please be specific: ie. alarm number showing on screen, if damaged give description, PM - Periodic Maintenance)

 

 

Medical Contact & Support

+1 800.970.2337
If you have any questions or require additional information, please contact the Medical Devices Group customer support or visit our online support page.