CTC Medical Repair Inc. | Repair Request Form Medical Equipment Repair Medical Instruments Repair Surgical Instrument Repair Surgical Equipment Repair

Tray Refurbishment

Repairs

- General Instruments

- Laparoscopic Instruments

- Power Tools

- Pin Cutter

- Endoscopes

- Endoscope Accessories

- Stainless Durables

- Defibrillator Paddles

- Genesis Pan

- Micro Instruments

Making of an Instrument

Mobile Truck Service

Repair Request Form

Custom/Prototype Project

Sterilizers / Washers

Repair Request Form

Account Information

Hospital Name:

Contact Name:

Phone:

Shipping Information

Contact Name:

Address:

City:

State:

Zip:

Billing Information

Department:

Contact Name:

Address:

City:

State:

Zip:

Tool Repair Information

Quantity	Description	Problems

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