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(833) 423-3786
Welcome to the new Adepto Medical RGA Form!
Thank you for your continued business, we hope the new features make your visit more enjoyable!
RGA
* Required
RGA Details
RGA Type
*
Select Type
Service
Warranty
Rental/Loaner Return
Device Quantity
*
PO
Pre-approved Cost (Per Device)
$
Shipping Label Quantity
*
Request Local KC/LA Pickup Instead?
No
Yes (Pre-authorized customers only)
Contact
Company
*
Phone number
Email
*
First name
*
Last name
*