Make a request

Submit a service application


With this form, you can send an application for maintenance
or repair of medical equipment manufactured by UTAS.

To register an application, please provide the information on your issue.

    * - required fields

    Please fill in the full name of your medical institution or representative company.

    Specify the name of the city only.

    Specify the name of the country.

    Select the type of equipment (model) to which the application is related

    Please indicate the serial number of the equipment. One application - one number.

    Please describe briefly the essence of your request

    Please use the official UTAS claim report form.
    You can download files in PDF, DOC or DOCX, and pictures in PNG, JPG or BMP.

    Please specify the contact person's full name

    Please specify the contact person's position in organization.

    Please start with the country code. (ex. +52...)