Valley Health System - Service & Repair Request

Valley Hospital Device RMA Request

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) #
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
Phone*
Alternate Phone
Email*
Secondary Contact
First Last
Message
Comments
This field is for validation purposes and should be left unchanged.