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

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)