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Aftersales case creation is for ACTEON product repair only

END USER INFORMATION

Doctor'S name *
PraCtice name
PraCtice telephone number *

 

RETURN SHIPPING ADDRESS

Attention to:
Complete SHIPPING address *
PRACTICE Email *
Acteon rep's email
PRACTICE EMAIL will be used to communicate information and status updates for your ACTEON repair.

 

Reason for REPAIR

 

EQUIPMENT INFORMATION (Please provide as much information as possible about your items)

ITEM 1  
Description:
aCTEON REFERENCE CODE
Serial number:
ITEM 2  
Description:
ACTEON REFERENCE CODE
Serial number:

 

Additional comments:

 

 

 

* the fields marked with an * are mandatory