Service form

SERVICE FORM

Every day, we do our utmost to ensure that our products are of the best quality and have a long service life. Despite all the effort, all the care and all the checks, technical products can still have a defect.

COMPANY NAME AND LEGAL FORM *

SALUTATION *

FIRST NAME *

LAST NAME *

EMAIL ADDRESS *

PHONE NUMBER *

CUSTOMER NUMBER, ORDER NUMBER, DELIVERY NOTE NUMBER OR INVOICE NUMBER *

PLEASE SELECT THE TYPE OF YOUR SERVICE REQUEST *

DESCRIPTION OF THE ISSUE *

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Please upload photos of the concerned items

Supported files: Images or documents

I hereby confirm the accuracy of the information provided in the electronic form and declare that I am authorised to make the statements on behalf of the company. *

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Your partner for Health & Care

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Your partner for Health & Care

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SERVICE FORM