RETURN MATERIAL AUTHORIZATION REQUEST

This area allows for the step-by-step creation of a packing slip to return your product(s) to Welch Allyn for repair or calibration.

If the device failure is associated with an event such as death, injury, or hospitalization, do not use this Request. Please contact us at the location nearest you at your local country's support line.

A minimum basic service fee may apply and includes: Cleaning, Diagnostics , Written Estimate, Functional Testing & ground return shipping. This fee is included in all estimates, and is waived if you are under a Welch Allyn Service Agreement. If you decline the estimate, this fee will still be charged.

Step 1 of 4: Complete Contact Information

First Name *

Last Name *

Email Address *

Phone *

Ext

Fax

Billing Address (Sold to Address)

Shipping Address

Shipping is the same as billing

Organization *

Address 1 *

Address 2

City *

Check here if your are a medical student. Please include a copy of your Medical School picture ID with your shipment.

Organization *

Address 1 *

Address 2

City *

Step 3 of 4: Complete Payment and Handling Information

A payment method is required prior to Welch Allyn beginning any repairs on your device(s). You will not be charged if your device is found to be under warranty or covered by a valid service agreement. You will not be charged until the work has been completed.

A valid service agreement number has not been provided for one or more of your devices. Please provide a credit card or purchase order payment method prior to submitting your repair request.

Don't start repairs without authorization

Opt out of repair emails

STEP 4 of 4: CONFIRM YOUR RMA INFORMATION

IMPORTANT: Be sure to click the "submit" button at the bottom of this page once you have confirmed your information.

You will then be brought to a page providing your 9 digit RMA number.

Billing Address and Shipping Address

Billing Address (Sold to Address)

Organization:
Address 1:
Address 2:
City:
State:
Zip Code:
Country:
Medical Student

Shipping Address

Organization:
Address 1:
Address 2:
City:
State:
Zip Code:
Country:

Contact Information

First Name:
Last Name:
Email Address:
Phone:
Fax:

Product Information

Payment Information

Payment Method *:
Card Type:
State:
Zip Code:

Payment Method *:
Customer Number:
Purchase Order:

Payment Method :

PanOptic Ophthalmoscope

KleenSpec Single Use LED Vaginal Specula

Connex Spot Monitor

FlexiPort Disposable Blood Pressure Cuffs

ProBP 2400 Digital Blood Pressure Device

Braun ThermoScan PRO 4000

CP 150 Resting Electrocardiograph with optional Spirometry

ABPM 7100 Blood Pressure Monitor

Green Series 300 General Exam Light

RETURN MATERIAL AUTHORIZATION REQUEST

Step 1 of 4: Complete Contact Information

Billing Address (Sold to Address)

Shipping Address

Step 2 of 4: Identify Items to be Returned

Step 3 of 4: Complete Payment and Handling Information

STEP 4 of 4: CONFIRM YOUR RMA INFORMATION

Billing Address and Shipping Address

Billing Address (Sold to Address)

Shipping Address

Contact Information

Product Information

Payment Information

North America

Asia & Pacific Rim

Europe, Middle East, Africa & India

Latin America

PanOptic Ophthalmoscope

KleenSpec Single Use LED Vaginal Specula

Connex Spot Monitor

FlexiPort Disposable Blood Pressure Cuffs

ProBP 2400 Digital Blood Pressure Device

Braun ThermoScan PRO 4000

CP 150 Resting Electrocardiograph with optional Spirometry

ABPM 7100 Blood Pressure Monitor

Green Series 300 General Exam Light

RETURN MATERIAL AUTHORIZATION REQUEST

Step 1 of 4: Complete Contact Information

Billing Address (Sold to Address)

Shipping Address

Step 2 of 4: Identify Items to be Returned

Step 3 of 4: Complete Payment and Handling Information

STEP 4 of 4: CONFIRM YOUR RMA INFORMATION

Billing Address and Shipping Address

Billing Address (Sold to Address)

Shipping Address

Contact Information

Product Information

Payment Information