handpiece repair service

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Customer# :

Customer P.O# :

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*Please enclose supporting documentation for warranty repairs

Check if Estimate is not Required

Check if Estimate is Required

(Estimate may delay turnaround time)

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Warranty Repair :

Yes No    

Make/Model :

Serial Number :

Nature Of Problem :

Warranty Repair :

Yes No    

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Code/Number :

Please Select Return Delievery

UPS Ground (No Charge) :

Second Day (Standard Day) :

Note: If there is no selection your repair will be shipped Second day

Toll free# 1-800-221-0750

39-23 62nd Street

Woodside,NY 11377

 

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*by submitting this work order, a ups return slip will be mailed to the address provided.