RMA Preparation & Decontamination Declaration

This form is intended for the return of medical appliances to Shoreline (UK) Ltd and should only be completed if it has been issued to you by our team. If a return has not yet been agreed or authorised, please contact us first to discuss and approve the return before completing this form. Once a return has been agreed, this form must be completed in full prior to any collection being arranged.

Name(Required)

First Last

Company(Required)

Position Held

Email(Required)

On-site Contact Number

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code

Collection Location

(i.e inside shutters, by back door etc)

Model(Required)

(This is usually on a data plate inside the appliance on the RHS)

Serial Number

(If available)

RMA Preparation & Decontamination Declaration

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