Return & repair form

Please fill out the form completely,
so that we can process your return as quickly as possible.

What would you like to return?

Would you like to return a dentaleyepad or another product?

dep-selection-other

Dental eyepad

Dental eyepad

Enter your serial number and the zip code of your purchase here.

For dentaleyepad returns: Enter the serial number and zip code here to automatically load your customer data.

Here you can find the serial number:

Serial number

Zip code

RÜ number

Date

Delivery address

Practice name

First name

Name

Street

Zip code

Place

Phone

e-mail

Invoice address

Practice name

First name

Name

Street

Zip code

Place

Phone

e-mail

Contact person

Contact person

Contact e-mail

Article description

Item description / Returns

Serial number

Purchase date

Customer no.

Error Description / Reason for Return

Error description

Desired processing

Other (please describe)

Message to the doctorseyes team

Communication

Data protection

I have read the privacy policy and agree to the processing of my data for processing the return.

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