Contact Information Contact name Contact Email Address Contact Phone Facility Information Facility Name Facility Street Address Facility City Facility Zip Code Device Information Product Oxicom 2000Oxicom 2100Oxicom 3000RM3WAVES Note: If you are attempting to send in any other item than listed please call our customer service representative directly. Please enter the serial number of the device Repair Request Information: Calibration/Preventative Maintenance Only(No Issues Noted.): YesNo Proper cleaning/bio-decontamination cleaning is required prior to sending any device for service/repair. Inadequate cleaning/bio-decontamination could lead to additional labor costs. Proper packaging is necessary to avoid shipping damage. Any damage will be evaluated upon receipt and communicated back to you in order to instigate a shipping claim if necessary. QC sticks need to be included with the Oxicom machine in order to allow Waters Medical Systems LLC to fully evaluate the performance of the machine prior to release. Acknowledgement of proper cleaning and packaging requirements Routing: Once this form is completed, select SUBMIT. If you do not receive your RMA to the Email listed above within two working days, please contact Waters Medical Systems Customer Service. PLEASE do not send your device in for service until you receive this RMA number or a delay is likely.