Please fill out the form below and take photos of the issue(s) in order to assist with evaluation. See bottom of form for photo examples.
NOTE: Product Return Forms MUST be filled out for each individual item.

    Customer Information







    Sales or Purchase Information

    Product Information

    Product Evaluation

    "SHIP TO" INFORMATION








    UPLOAD DOCUMENT


    Did Your Shipment Arrive Damaged?

    IF THE UNIT’S DAMAGE OR VACUUM LOSS IS A RESULT OF TRANSPORT DAMAGE AND NOT SHIPPED THROUGH AN IC BIOMEDICAL FREIGHT ACCOUNT, PLEASE MAKE A CLAIM WITH YOUR FREIGHT COMPANY FIRST.

    Please provide photos or a video of unit & packaging (if necessary).
    A video may be easier to highlight damage or symptoms, if present.

    Image A

    Image A:
    Bagged with Inspection Label

    Image B

    Image B:
    Back of Tank

    Image C

    Image C:
    Side View

    Image D

    Image D:
    Front of Tank

    Image E

    Image E:
    Side View

    Image F

    Image F:
    Top View

    Image G

    Image G:
    Top View

    Image H

    Image H:
    Top View

    Image I

    Image I:
    Top View

    Image J

    Image J:
    Evacuation Plug

    Image K

    Image K:
    Tank Bottom

    Image L

    Image L:
    Side 1 of Box

    Image M

    Image M
    Side 2 of Box

    Image N

    Image N:
    Side 3 of Box

    Image O

    Image O:
    Side 4 of Box

    Image P

    Image P:
    Top View of Box