Please fill out this form in its entirety

    Failure Date (DD-MM-YY) *required

    Purchase Date (DD-MM-YY) *required

    Computer Model *required

    Serial Number *required

    Computer Owner Full Name *required

    Shipping Address *required

    Shipping Country

    Phone Number *required

    Email Address *required

    Dealer (if not applicable, please type in NA)

    Please describe the problem(s) you are having with your computer:

    Number of dives on computer *required

    Images of your broken dive computer (Max. 2MB)