Newsletters
Glossary
Service & Support
PASCAL Support
AMADEUS Support
FEMTO LDV Support
GALILEI Support

User login
Newsletters
Glossary
Service & Support
FEMTO LDV
AMADEUS II
FEMTO LDV
SWISSBLADE
PASCAL
GALILEI G2
NEWS

Please register!

Get Access to additional content.

[more]
EVENTS

WOC 2012

World Ophthalmology Congress, Abu Dhabi, Feb. 16-20, 2012

[more]
Last Update: 11.01.2012
Imprint

PASCAL RMA Request Form

Owner: S & A   Version: 18.07.2007  

RMA# Request / Complaint Form

PASCAL Support and Service > RMA Request
Please report your problem with the PASCAL Tonometer exactly according to this procedure (PDF)
Fields marked with * are mandatory

Distributor

Name:
* 
Contact Person:
* 
Address:
* 
City/ZIP:
* 
Country:
* 
Phone/Fax:
* 
E-Mail:
* 
Confirm E-Mail:
* 

End consumer

Name:
 
Contact Person:
 
Phone:
 
E-Mail:
 

Material

Within 12-month Warranty?
PASCAL s/n:
 
 Yes  No
Sensor Tip s/n:
 
 
 Yes  No
 
 Yes  No
 
 Yes  No
 
 Yes  No
Printer s/n:
 
 Yes  No
Battery:
 Disposable  
 Rechargable
Other
 
 

Notification type

Is this an RMA# Request and/or a Complaint and/or an Adverse Event ?
Has a patient been injured or was there a risk of injury?
 
 Yes  No
If yes, have the Regulatory Authorities been notified?
 
 Yes  No
Problem description (Please describe your problem as exactly as possible)*
Ziemer Ophthalmics will contact you by phone or e-mail and will either:
  • provide recommendations that will help you solve the problem, or
  • ask you to return your product for inspection and / or repair. In this case, you will receive a Return Authorization Number (RMA#) and instructions for how to ship the unit.
Do not send any PASCAL unit or accessories back to us without an RMA number