Return Merchandise Authorization (RMA) Request Form

Return Merchandise Authorization (RMA) Request Form

Please fill out the form below to request a return or exchange if you:

Are located in the USA or Canada
Or purchased medical equipment made in the USA or Canada

Bender's Warranty Statement

Request Type*

Date purchased*

First Name*

Last Name*

Email*

Phone*

Company*

Account Sector*

Country*

US State:*

State/Province

Product Name and Serial Number*

Detailed Reason for Return*

Please verify you are not a robot