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Contact

IMPLANT REPLACEMENT FORM

Replacement

Please fill out the following form to process your replacement.

Shipping Cost - we will cover the shipping if we made a mistake, customer to cover shipping in all other cases.

Click "Add Item" below to fill out your Implant Replacement Form
Quantity LOT # Part # Return Type What item would you like your return to be substituted with? Actions
         

Please remember to...

  • Sterilize the product and mark it as STERILE
  • Verify the terms and conditions
  • Complete the form above as completely as possible
  • Attach the form to the Product or write the Patient ID on the container
  • Have the Clinician sign the form
  • Send Product and form in protective packaging via a trackable method
When finished adding items, Submit your completed RMA
MicronMapper Application