Fill out this form to request an RMA for DentalEZ Products

Information from your DentalEZ Invoice or your Purchase Order are required to complete this form.

Asterisk means a field is required.

Order Information

DentalEZ Invoice OR Purchase Order #*

One Invoice or PO number per request, please.

Part Number(s) being returned*:

Part number(s) must match the invoice.

Contact Information

Company Name*:

Your Name*:

Email Address*:

Phone*:

Fax:

City/State:

Return Information

Reason for Return*:

Explanation and Comments:

Serial Number(s): (if applicable)*:

Please enter serial numbers for parts that have them.

Hour Meter Reading (if applicable)*:

Hour Meter readings are required for items with meters.

Equipment Install Date:

Install Date is required for Warranty Returns.

DentalEZ Tech Call# (if applicable):

Return/Credit Policy:

No credits will be issued, nor will any merchandise be accepted without authorization. This authorization expires if the products listed are not received within 30 days from date authorization is approved. The amount of credit authorized will be at the sole discretion of DentalEZ. There will be a 15% handling charge ($25 min) for items returned for restocking. Opened products or product returns more than a year old cannot be returned for credit.

Required*:

I acknowledge that I have read and understand the above return/credit policy.

Links

Order Information

Contact Information

Return Information

Return/Credit Policy: