Get Oticon Loss And Damage Form

This guide provides step-by-step instructions for completing the Oticon Loss And Damage Form online. Whether you are filing a claim for loss, theft, or damage, this comprehensive guide will help you navigate each section of the form with confidence.

Follow the steps to fill out the form accurately and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Start by entering the 'Ship to Customer Number' and 'Bill to Customer Number' in the designated fields.
3. Provide your phone number, company name, and address details including city, state, and zip code.
4. Input the PO number if applicable, followed by your additional contact details, including another phone number and company name.
5. Next, fill in the 'Patient Information' section. Include the patient's name and specify if they are a child or a Medicaid patient.
6. For the 'Non Delta Product Information' section, record the model, color, and serial number of the product. Also, indicate the dispensing date.
7. Indicate if the product has any speaker units, documenting the serial numbers and sizes needed.
8. Review the claim requirements and guidelines, ensuring that all necessary information is filled correctly.
9. Sign the form in the designated areas for both the patient and dispenser, confirming your authorization for Oticon to proceed with the claim.
10. Upon completing the form, you can save any changes, download, print, or share it as needed.

Complete your documents online today and ensure your claim is processed smoothly.