meditec sàrl — Technical Support

1) Customer

Organization / Company *

Organization type

Department/Ward

Contact person

Role

Phone

Email *

PO/Cost center

Street, No.

ZIP

City

2) Site & Access

Room / asset location

Access notes (parking, registration, floor, safety)

Availability / time window

Remote support? Yes No

3) Device

Manufacturer

Model / Type

Device category

Serial number

Asset ID

Commissioning date

Maintenance contract

Safety test due

Test standard

IT Integration

4) Issue

Priority

Impact

Since

Error code

Description

0/1500 characters

Patient risk Outage Loaner required

5) Attachments

Screenshots/photos/logs (max. 10 files). Note: mailto fallback usually doesn’t support attachments; server endpoint required.

6) Submit

Please do not enter patient data. See Privacy Policy.

Consent given (optional)

Subject is generated from organization, device and priority.

Technical Support