Return Merchandise Authorization (RMA) Request

Return Merchandise Authorization

Please provide the following information to process your return request.

Today's date

Month

Day

Year

Customer type

Dealer

End customer

First name

Last name

Email address

Phone number

Dental office name

Equipment location address

Country/Region

Address

City

Zip / Postal code

Additional problem information

Share all relevant details about the issues you're having with the equipment

Upload issue documentation

Please upload photos or videos clearly showing the issue you are experiencing

I confirm that the information provided is accurate and I understand the return policy terms

Submission of this form authorizes Video Dental Concepts to charge approved fees.