Sensor Repair Request Form
Please make sure you fill out the form below in it's entirety for the fastest turnaround. Once you have filled out the form below, please send the broken sensor to:
360 Raleigh St.
Holly Springs, NC 27540
How did you find us?
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Phone Number and Best Time of Day to Contact:
Return Mailing Address:
To the best of your ability, please detail the problems you are experiencing with your sensor equipment:
Which Digital Dental Sensor model are you sending?
Please Select...Kodak RVG 5000Kodak RVG 5100Kodak RVG 6000Kodak RVG 6100Schick CDRDexis PlatinumGendex GXS-700Other (see below)
If "other" above, please specify. Call us with questions
Sensor Serial Number (1)
Sensor Serial Number (2)
If digital dental sensor is not repairable, reassemble?
Yes, if not repairable, reassemble ($45 fee) No, if not repairable, please do not reassemble
Please detail the exact contents you will be shipping to us below:
I have spoken with a technician or sales representative on the phone
I have not spoken with a representative, please call me to confirm