Geisinger Health

Request Repair Services for Geisinger Health

Welcome! To request repair services, please complete the online form below. An RMS Omega representative will be in contact with you shortly to provide a Return Merchandise Authorization number (RMA) or corresponding information for each request.

For assistance, please e-mail helpdesk@rmsomega.com. Thank you!

Request Service or Repair
Action Required*
- Open New Onsite Service Call
- Open New Phone Support Call
- Obtain a Return Merchandise Authorization (RMA) #
Manufacturer
Please Select a Device

Device Serial Number for Repair*

Model/Part Number	Serial Number	Problem Description

Please provide the serial number for each device and a brief description of the problem.

Depot Location
Parts Depot Location
Please select a location from the drop-down.
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Address
Street Address Address Line 2 City State ZIP Code
Contact Information
Primary Contact*
First Last
Job Title / Department
Phone*
Email*
Please Select Your Support Region
Support Region Email
Support Region Email
Support Region Email
Message
Name
This field is for validation purposes and should be left unchanged.

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Geisinger Health – Service Request Form

Geisinger Health

Request Service or Repair

Depot Location

Contact Information