Mercy Medical Center - Service Request Form

Repair Services for Mercy Medical Center

Welcome! To request repair services, please complete the form below.

Please send repairs to 9635 Philadelphia Road, Baltimore, MD 21237.

For assistance, please e-mail: service@rmsomega.com

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

Items to Service or Repair*

Model/Part Number	Serial Number	Problem Description

Contact Information
Hospital Name*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Primary Contact*
First Last
Job Title/Department
Phone*
Alternate Phone
Email*
Secondary Contact
First Last
Message
Name
This field is for validation purposes and should be left unchanged.