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Products
Fundus Imaging Systems
iCare EIDON
iCare EIDON AF
iCare EIDON FA
iCare DRSplus
Perimeters
iCare COMPASS
Hand-held Tonometers
iCare IC200
iCare IC100
iCare TA01i
iCare HOME2
iCare HOME
iCare CLINIC
News and events
ABOUT US
Clinical information
Find Your Rep
Blog
For patients
Clinic login
Order probes
Tonometry Service Request Form
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Serial Number
*
Service Number
Rep Name
Case Tracker #
CUSTOMER
Customer #
Order #
Company
*
Address
*
Street Address
City
State *
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State
ZIP Code
Phone
*
Contact Name
*
Fax
Email
*
Please check the appropriate box
Dropped Device
Measurement results are too low
Measurement results are too high
Measurement results are inconsistent
Probe moves sluggishly or doesn't move at all
Device constantly warns about low battery
Other
The following error message(s) appears frequently
E01
E02
E03
E04
E05
E06
E07
E08
E09
Other
Would you like a cost estimate for service?
Cost estimates are performed at no charge if you have a service agreement with iCare. If you do not have a service agreement, a $50 fee will be charged if service is refused after receiving the estimate.
Yes
No
Would you like a loaner device?
If yes, loaner devices are provided at no charge if you have a service agreement with iCare. If you do not have a service agreement with iCare a $95 fee will be charged for the loaner device.
Yes
No
Consent
*
I understand that I am responsible for the full cost of the loaner tonometer should it be damaged, lost, or not returned.