Return Merchandise Authorization (RMA) Request Form

Please fill out the below form to request a return or exchange if you:

  • Are located in the United States
  • Or purchased medical equipment made in the US
Request Type:
Name:
Company:
Phone:
E-mail:
Detailed reason for return:
Product name and serial number:

Please enter each product name and serial number on a separate line.

Example:
RCM470LY-13 12345678

Submit