Online Repair Service Report Filing


  1. Make sure to fill all field with “*”.
  2. RMA# and RMA form related info can be founded in the email sent to Service Provider when end user filed that online.  One (1) report can file up to four (10) same RMA group number (i.e.: X-1, X-2, X-3). Make sure to retrieve, save or print for record.
  3. Check to see Model Name and SN are correctly stated as there are times when end user incorrectly write down the Model Name and SN.  If Service Provider see this mismatching occurred (from email RMA and actual device), please inform AGN immediately with RMA# and incorrect info.  As those will jeopardize warranty granted.
  4. AGN recommended to submit Repair Service Report after each complete repair service. However, if the Service Provider decided to do this later, please make sure all information are jotted down.  Information including but not limited to Return Shipment Date, Return Shipment Carrier Name-Type, and Return Shipment Tracking Number. 
  5. Write down any special finding or notes for each case.
  6. Service Provider shall receive an email confirmation of the Repair Service report. Shall Service Provider find anything wrong, please make sure to use the same email to forward to AGN and telling us the incorrect part within 72-hours of submission using the received auto-reply email and simply make correction on the email (highlight with “RED” color).
  7. Shall Service Provider decided to use this email confirmation as invoice to AGN, make sure all submission need to be kept on file for proof of record. AGN will not accept any mistake correction after 72-hours of submission period.  The only way to correct this is by email.  AGN will not accept any information correction over the phone. 

Online Repair Service Report Filing

    Basic Info

    Incoming Shipping Info

    Repairing Item

    Item #

    Replacement parts (please select which has been used for replacement; possible to select more than one)

    Revolution series

    Rotor set

    Other set parts

    NSK O-ring Parts

    KaVo/Sirona O-ring Parts

    Star O-ring Parts

    WH O-ring Parts

    Other O-ring Parts

    Evolve series

    Rotor set

    Repair Item Return with following done

    0.5 hour as increment base (i.e. 0.5, 1.0, 1.5, 2.0)

    Outgoing Shipping Info

    Submitting format: PDF or JPG or PNG with maximum file size 1MB
    (upload as many files as you wish. File name included #1, #2 according to each case)

    (Please started with #1: as 1st repair item, #2: as 2nd repair item before writing special note for each case)

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