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Online Repair Form

Welcome to the Pacific Medical Online Repair Order Form. 

Simply fill out the form below. After your order is submitted, you will be contacted by our wonderful customer service team to get you a shipping label. Once you have your shipping label printed, pack everything up, send it in, and we will send you a tracking number to notify you when your order is on its way back to you! 

If you would rather send in your repair form, you can download a free shipping label by clicking here.


Send the products you would like repaired with the repair form to: 

Pacific Medical LLC
212 Avenida Fabricante
San Clemente, CA 92672

Once submitted, you will be contacted by one of our wonderful customer service representatives with your RGA number. 
If you have any questions, please email info@pacificmedicalsupply.com or call 800-449-5328. 
We accept Master Card, Visa, American Express, Discover, Check, Bank Transfers and P.O.'s.

Copyright © Avante HS 2023 212 Avenida Fabricante, San Clemente, CA 92672 (800) 449-5328