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X-Ray Sensor Repair
IOS Scanner Repair
Intraoral Camera Repair
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Ship to: Imagin Systems Corporation
517 Marine View Ave. #H
Belmont, CA 94002
RMA# & Date
Imagin Use only
Street Address Line 2
ITEM DESCRIPTION FOR REPAIR: SHIPPING INSTRUCTIONS:
IOS 3D CAMERA
PLEASE SELECT A RETURN SHIPPING SPEED,
IS STANDARD IF LEFT BLANK
Tell us what is happening to the best of your ability
Imaging Software used (i.e. Eaglesoft, Dexis, VixWin, Apteryx) List accessories ingluded:
PRINT THIS FORM NOW BEFORE SUBMITTING IT!
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Make Sure You Put a Copy of this Form in the Shipping Box!
Please Read the Following Conditions Carefully:
• Please take care when packaging your items to prevent damage in transit.
• All repairs will be given a 90-day limited warranty for parts and labor unless otherwise stated on the quotation provided. Equipment left over 90 days will be scrapped & we aren’t responsible for them after that point.
• If an Item is unrepairable a $50 return shipping/handling fee will need to be made to receive items back.
• Please include the amount of insurance you want on return shipping; we are not responsible for lost items. Roughly estimated $1000 insurance
equals $10.00 of additional shipping cost. All Shipments without stated Insurance will automatically have $1000 insurance added.
By Submitting this Form, You Understand the Conditions Above
SUBMIT THIS FORM
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you must organize your own shipment due to liability)
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