Luisa RMA - Movair

Return Request From: Follow the steps below to create a return material authorization (RMA). Once submitted, a customer service representative will verify the information and provide return instructions. If assistance is needed, please contact customer service at (512) 326-3244.

Step 1: Provide the follow contact information

Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Name(Required)

Return Address, if different from company address:

Return Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Name

Step 2:

Provide the following device information(Required)

Date of Issue:

Serial Number:(Required)

Error Code(s):

Product Number

Lot Number

PO

If no error code: please provide a description of the issue:(Required)

Optionally describe the issue

Describe any troubleshooting that was performed:

Step 3: Provide adverse event information

Was there any adverse event related to this issue?(Required)

Yes

No

Severity of adverse event:

Detailed description of event:

Step 4: Provide as much detail regarding patient and device setup as possible

Patient Age:

Which kind of breathing circuit?

Patient Sex:

Which kind of patient interface?

Nature of disease

Bacteria filter?

How was the device used? (Nocturnal, 24 hours, etc.)

Humidifier connected? If so, which?

Pressure Settings

Additional oxygen

Yes

No

Power Source

Mains/Wall outlet

Battery

If so, how many l/min

Has external battery been used?

Yes

No

If not connected through LUISA oxygen port, describe connection to oxygen source

Please refer to the LUISA terms and conditions.

Check box for I accept the Terms and Conditions(Required)

I accept the Terms and Conditions

View Full Terms and Conditions

*Returned Good Policy: Authorization for any returns MUST be obtained from MOVAIR Customer Service. Returns and exchanges or any other returns must ship freight prepaid by DEALER unless MOVAIR authorizes different shipping arrangements. Returns due to a MOVAIR error or warranty claim may, with authorization, be returned freight collect or with freight pre-paid call tag issued by MOVAIR

Remote Monitoring is Now Available with LUISA®, through the prisma CLOUD, for Physicians and DMEs

Remote Monitoring is Now Available with LUISA^®, through the prisma CLOUD, for Physicians and DMEs