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CPAP Service Request 2017

CPAP Service Request 2017

$ 100.00

 Normal service is recommended, but not required, every 2 years.   Operating conditions, volumes and geographic considerations vary from user to user.  Therefore, users should continually monitor the effectiveness of their units and when in doubt, contact us.

** By purchasing this service ticket, I recognize that if I have damaged parts that are beyond typical “service” wear and tear, I will be contacted before the work is performed so that I can understand my total cost and/or Trade-In options and will be sent a new agreement form for signing. 

After purchase is completed a return label (pre-paid) and packing slip for your units to be serviced along with instructions will be emailed.

LOANER Agreement (If Loaners Are Needed)

  • When your units are serviced and returned to you, a return label and packing instructions will once again be emailed to you to return the loaner units.
  • Your loaner units and serviced units will be returned to the address on the service agreement.
  • Once you receive your serviced units, you agree to return the PORTO2VENTTM units on loan within 5 days of receiving your serviced units.
  • Failure to send loaner units within 10 calendar days of receiving your serviced units will result in you being invoiced 599.00 per unit.
  • I agree to the above costs plus any applicable state sales tax and authorize Emergent Respiratory to service my units and will be invoiced once I return this signed agreement.

 By Purchasing this service ticket I acknowledge and agree to the terms identified in the preceding paragraph and authorize Emergent Respiratory to begin the process.

 



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