Post-Market Surveillance

Compliant Form
Warranty claim

With this form you can report any problems, accidents or adverse effects encountered with the use of our devices. For reports relating to purchase information, support for orders and shipments, or any other communication, we ask you to use the contact form available here.

Refer to our Privacy Policy to know how your data will be managed; by submitting the following form with your data, you accept this information and give your consent to their use.

Your Name *

Your Company

Telephone number

Your Email *

Enter your email here

Reason of your report *

Give a title to your report

Which of the LO RUSSO RETRACTOR Kits are you sending the report for? *

Size 0

Size 1

Size 2

Lot number *

Enter the lot number of the device you are reporting

Purchase date *

Enter the purchase date of the device

Purchase order or invoice number *

Enter the number of your purchase order or purchase invoice

Purchased by *

Indicate if the device was purchased in our online store or from an authorized dealer (if so, specify the name)

Invoice file *

Attach the purchase invoice or purchase order confirmation email

Describe the reason for your complaint *

Separa gli indirizzi e-mail con una virgola.

Send

With this form you can send us a request to activate the warranty program on our devices. Before proceeding, we invite you to read the warranty conditions available in the Purchase Terms and Conditions. For reports relating to purchase information, support for orders and shipments, or any other communication, we ask you to use the contact form available here.

Consult ours Privacy Policy to know how your data will be managed; by submitting the following form with your data, you accept this information and give your consent to their use.