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Product Feedback

Please provide the information requested below when submitting your product feedback. Areas indicated with an asterisk (*) are required data entry fields and must be completed to submit this Product Feedback Form.

 

Customer Contact Name

Describe patient/user’s current status and whether medical intervention was required
Did a second device complete the procedure successfully?
Was this device used on a Hologic System?
Would you like a written response at the conclusion of the device complaint investigation?
Is the device in question available for return for investigation and analysis?
Has the product been used on a patient or is it contaminated in any way? NOTE: Do not ship contaminated product back to Hologic prior to receiving a biohazard container
What address would you like the return kit shipped to? The return kit will include a biohazard container when contaminated products are being returned.
What address would you like the return kit shipped to? The return kit will include a biohazard container when contaminated products are being returned.