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Factory Repair RMA Request Form

If submitting more than one instrument to be repaired for the same customer, a new form will need filled out for each instrument. The status of your repairs can be tracked on your Factory Repairs Spreadsheet available in Drive.

After completion of this form, RMA information and paperwork will be sent via email. An estimate will not be provided for Tonopens and Tonometers as they will be billed out according to the flat rates below.

Current Flat Rates:

$775 Reichert Tonopen Calibration

$500  Medtronic/Mentor Tonopen XL Calibration

$500  Haag-Streit Tonometer Calibration

Current
Flat Rates

$775

$500

$500

Reichert Tonopen Calibration

Medtronic/Mentor Tonopen XL Calibration

Haag-Streit Tonometer Calibration

Customer Information

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Instrument Information

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This field is required
Value is required
Value is required
Value is required
Value is required

Shipping Information

*If you prefer to pickup the instrument at Optics for delivery, select Optics Incorporated below.

After the repair is complete, the instrument should be shipped to:

Value is required

If being shipped to the customer, please provide the address below:

Thank you!

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