Flat Panel Service Report

This report is to be submitted on each Flat Panel removed from service. Each flat panel must be returned with a completed Service Report describing the reason for return, operating conditions with install and remove dates in order to receive warranty consideration.

Before an RMA # can be issued on “Out Of Warranty Returns” a PO for $750.00 needs to be supplied at time an RMA# is requested. Note: All products must be cleaned of blood, contrast media or body fluids before returning.

Please fill out this form completely and hit submit. We will then email you further instructions along with an RMA number. Please do not ship any material to us without an RMA number; we will not be able to accept it.

Please Return within 90 days of RMA# Issued. After 90 days, RMA# will be closed and you will need to request a new RMA# to return your product.

Once you have received your RMA, please ship material to:

VAREX IMAGING CORPORATION
1678 Pioneer Road
Salt Lake City, UT 84104-4298
Receiving Door #15

PLEASE SHOW THE RMA# ON THE OUTSIDE OF ALL PACKAGING

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Defect Information

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How long has the system been operating before you see the defect?

Please describe the system set-up at the time of the failure:

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