[B2B] Repairs

Repairs & Services

Please fill out this form to initiate a product repair request.

Our goal is get your issue resolved as quickly as possible. Please complete the form below with as much detail as possible. We will be in touch with you to communicate regarding any missing information or delays that may occur.

Country*

Type of request*

Product Repair-Complaint or Malfunction

Product Scheduled Service (No Complaint)

Ottobock account number

Postal code of facility

Facility Name*

Your first name*

Your last name*

Your email address

Your phone number

Please choose your Sales Rep*

Andy Mason (Alberta, Saskatchewan, Manitoba)

Courtney Carter (Ontario)

John Marsh (British Columbia)

Martine Laforest - Prosthetics (Quebec & Eastern Ontario)

Sylvain Talbot - Orthotics (Quebec & Eastern Ontario)

Andrew McLean - Prosthetics & Orthotics (Newfoundland, Prince Edward Island, Nova Scotia, New Brunswick)

Product(s) impacted (e.g. 3R60, 3B5-4, etc.)*

Serial or LOT number (if unknown, insert N/A)*

Do you require a loaner unit?*

Yes

No

PO you would like to attach to loaner

If device is MPK, Cut Length of pylon is needed*

Is the product under warranty?*

Yes

No

I don't know

If your product is not under warranty, you may be required to pay a loaner fee. Someone will be in touch for more information.

Main complaint*

Description of issue(s) - Please be as specific as possible

Department that provided the experience

Please describe your experience

Invoice, PO, or Sales Order # (if not known, please insert n/a)

Instructions (PDF) for locating the serial number and LOT if needed.

Are you seeking a credit or a replacement?

Credit

Replacement

Are you returning the product due to a defect or malfunction?

Yes

No

Why are you requesting a return? Please be as detailed as possible.

Any notes or comments you would like us to be aware of?

What is your client's complaint with the device?*

Did the patient experience any of the following?*

Please contact CA.Repairs.Trials@ottobock.com immediately.

Detailed description of the circumstances and consequences*

Was medical treatment required?*

Yes

No

Unknown

Discomfort for the affected person*

None

Minor

Moderate

Major

Effect on the daily routine of the person affected*

None

Minor

Moderate

Major

Was further usage of the medical device possible as intended?*

Yes

No

Please provide more details

Was a product liability claim submitted?*

Yes

No

Unknown

Was an authority informed about the event?*

Yes

No

Unknown

Name of the authority

Do you have images or video to upload that illustrate the malfunction?

Yes

No

Please upload a photo or video clip capturing any known issues or malfunctions. (optional)

Total size of all files must be less than 20MB. File types accepted: jpg, jpeg, png, pdf, wmv, avi, mpg, mpeg