Trudell Medical | Complaint Submission

First Name *

This field is required.

Last Name *

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Email Address *

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Telephone # *

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Address Line 1 *

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Address Line 2

City *

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Province *

This field is required.

Postal Code *

This field is required.

Model Name *? (View Models)

This field is required.

? The model name is located on the bottom of your compressor.

# of units *

Serial Number *?

This field requires a six digit number.

? The serial number

is located on the bottom of your compressor.

Lot Number *?

This field requires a six digit number.

? The lot number

is located on the bottom of your compressor.

2: Serial Number *

This field requires a six digit number.

2: Lot Number *

This field requires a six digit number.

3: Serial Number *

This field requires a six digit number.

3: Lot Number *

This field requires a six digit number.

4: Serial Number *

This field requires a six digit number.

4: Lot Number *

This field requires a six digit number.

5: Serial Number *

This field requires a six digit number.

5: Lot Number *

This field requires a six digit number.

6: Serial Number *

This field requires a six digit number.

6: Lot Number *

This field requires a six digit number.

7: Serial Number *

This field requires a six digit number.

7: Lot Number *

This field requires a six digit number.

8: Serial Number *

This field requires a six digit number.

8: Lot Number *

This field requires a six digit number.

Retailer Name *

This field is required.

Date of Purchase *

This field is required.

City *

This field is required.

Province *

This field is required.

Has the compressor been used? *

Yes

No

This field is required.

How often?

Description of Complaint *

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Please include as many details as possible and photos, if possible.

Did the incident result in illness, injury or death? *

Yes

No

This field is required.

Terms and Conditions *

I have read and understood the privacy policy and terms and conditions.

This field is required.

It may take up to 24 hours to receive your confirmation email. To make sure it doesn’t land in your spam/junk folder, please add info@trudellmed.com to your contacts list.

If you are having trouble registering or if you have any questions about your OMBRA* compressor system, please contact us at info@trudellmed.com or call our toll free line at 1-866-510-0004. Thank you for your time and for choosing the OMBRA* brand.