DialyGuard RGA Service Order Form

Instructions

Mesa recommends annual replacement of your measurement module to ensure proper calibration and compliance.

Important Reminders

All equipment sent to Mesa for service will be serviced at current pricing. Only send components that require service and/or calibration. 90XL displays do not require calibration. Please send only if service is required.
Use this form for calibration and repair service for your 90XL and pHoenix meters. If you have questions about your pHoenix XL meter, please contact DGsupport@mesalabs.com.
pHoenix XL meters do not need to be sent in for yearly calibration. The pHoenix XL meter handle is connected to a replaceable module that can be ordered from Mesa Labs with part number 36-00310.

RGA Service Order Form Process

Complete the Service Order Form below. Upon submission, please print the confirmation page and include it in your meter shipment to Mesa Labs. Failure to include a service order form will result with your meter not proceeding to service.
Typically within 24 business hours, we'll prepare and send you a detailed quote including part numbers and pricing. Please review the serial numbers carefully when you receive it to confirm accuracy.
Shipping instructions will be provided with the quote. Please check your email.

PO #* (use N/A if paying by a credit card or if planning on submitting a PO after RGA/Quote is received)

Complaint # (if one has been provided to you by Mesa Labs)

Will you be paying by credit card?

Yes

First Name*

Last Name*

Company Name*

Email*

Phone Number*Enter your country code followed by your phone number in the following format: +[Country Code]-[Area Code]-[Local Number]
Example: +1-303-987-6543

Shipping Address

Ship Via*2nd Day, Overnight or Saturday Delivery shipping will incur higher cost due to weight of product

Customer Shipping Account # (if applicable)

Address Line 1*

Address Line 2

City*

State/ Province*

Zip/ Postal Code*

Country*

Check if billing address is the same as shipping address

Billing Address

First Name*

Last Name*

Company

Address Line 1*

Address Line 2

City*

State*

Zip/ Postal Code*

Country*

IMPORTANT: To enter multiple serial numbers, please click the "add another product" button at the bottom and enter multiple serial numbers on separate lines.

Product 1

Type of Meter to Calibrate*Note: For pHoenix XL meters, please contact support at DGsupport@mesalabs.com

Serial Number*Please include the alphabetical (capitalized) letters followed by numbers without any spaces or dashes.

Expedite Service $60 USD

Yes

Describe issue (please be as detailed as possible)

Total cost: $

Instructions

Shipping Address

Billing Address

Product 1

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