Online Service Request

Serial Number: *

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Model Number:

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Hospital Name: *

Address 1: *

Address 2:

City: *

State:

Contact Name: *

Contact Email: *

Contact Phone: *

Current Location of Unit: *

e.g. Engineers department.

Description of Symptom(s):

Describe all the symptoms the bed/stretcher is displaying.

Description of Fault if known:

Describe all the symptoms the bed/stretcher is displaying.

If the symptom is an electrical fault, has a reset been completed:

Yes

N/A

Upload an image:

Supports jpg, png, and gif. Max upload size 5 MB.

Terms and Conditions: *

I have read and understood Howard Wright Limited's warranty policy.

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