Sedation Stethoscope Service Request

Request for Service
Before requesting service, please note that certain models have been discontinued and are no longer serviceable.

IMPORTANT!! See the 2024 Update to determine if your unit is serviceable -- PLUS an exclusive trade in offer!

All questions with a red asterisk * must be completed before submitting the form.
Email Address*
example@example.com
Phone Number*

Area CodePhone Number
Doctor's Name*

First NameLast Name
Practice Name*
Complete Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Number
Helpful if Available
Description of the Issue*
Upload an image of your device showing QR codes for both the chestpiece cable and amplifier.*

Browse Files
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Request for Service