e-mail  |   biomed@actservice.net

 


Please fill out the following form to request depot repair service. Once you have completed filling all information, please package the materials appropriately and ship to us using our shipping instructions.
Facility Name:
Facility Address:
City:
State:
Zip:
Contact Name:
Contact Phone:
Contact Email:
Purchase Order #:

Items to be returned for Compliance Service
(please provide ALL information listed below for each unit being submitted)

 
Manufacturer
Model
Serial Number
Unit 1
Unit 2
Unit 3
Unit 4
Additional Comments / Instructions
     

About Us | Our Services | Service Types | Depot Repair | Onsite Service | Lease a Tech | FAQ | Links | Home