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Aftersales case creation is for ACTEON product repair only

END USER INFORMATION

Doctor'S name *
Pratice name
Pratice telephone number *

 

RETURN SHIPPING ADDRESS

Attention to:
Complete SHIPPING address *
PRACTICE Email *
Acteon rep's email
 We will use your practice email to communicate information regarding your ACTEON repair (for example the quote if needs be)

 

Reason for REPAIR

 

EQUIPMENT INFORMATION (Providing additionnal information regarding your repair is optional but always helpful)

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