LOUPE AND LIGHT REPAIR FORM

1. Submit repair request with the form below to begin process.
2. Be sure to include a copy of your confirmation email received after submitting your request with your shipment.
3. Thoroughly clean and disinfect your loupes. SurgiTel may charge cleaning fee if product is deemed unsanitary or unsafe.
4. Please do not include third-party products.
5. Package your loupes safely and in appropriate shipping materials inside a box in preparation for shipment.
6. Keep a copy of your shipping receipt for your own records.

Ship your packaged loupes/light to:

SurgiTel
Repair# (See automated email)
77 Enterprise Drive
Ann Arbor, MI 48103